- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,108.64 / $13,450.90 / $18,050.00
| Facility | | $8,108.64 | $13,450.90 | $18,050.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,816.05 / $11,816.05 / $11,816.05
| Facility | | $11,816.05 | $11,816.05 | $11,816.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,752.45 / $11,827.02 / $18,597.34
| Facility | | $6,752.45 | $11,827.02 | $18,597.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,658.28 / $10,830.00 / $24,837.52
| Facility | | $6,658.28 | $10,830.00 | $24,837.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,905.18 / $10,668.27 / $15,112.90
| Facility | | $7,905.18 | $10,668.27 | $15,112.90 |