- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,543.31 / $15,642.10 / $20,423.00
| Facility | | $7,543.31 | $15,642.10 | $20,423.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,284.46 / $38,251.00
| Facility | | $5,840.42 | $14,284.46 | $38,251.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,838.32 / $14,614.35 / $22,082.46
| Facility | | $8,838.32 | $14,614.35 | $22,082.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,753.88 / $20,753.88 / $20,753.88
| Facility | | $20,753.88 | $20,753.88 | $20,753.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,734.29 / $14,722.64 / $22,735.22
| Facility | | $12,734.29 | $14,722.64 | $22,735.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,284.46 / $38,251.00
| Facility | | $5,840.42 | $14,284.46 | $38,251.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,284.46 / $29,893.50
| Facility | | $5,840.42 | $14,284.46 | $29,893.50 |