- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,379.87 / $11,695.50 / $19,417.30
| Facility | | $7,379.87 | $11,695.50 | $19,417.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,754.00 / $6,754.00 / $6,754.00
| Facility | | $6,754.00 | $6,754.00 | $6,754.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,483.58 / $11,210.84 / $18,991.40
| Facility | | $7,483.58 | $11,210.84 | $18,991.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,589.82 / $12,474.59 / $17,862.09
| Facility | | $9,589.82 | $12,474.59 | $17,862.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,266.88 / $11,983.27 / $33,463.60
| Facility | | $6,266.88 | $11,983.27 | $33,463.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,266.88 / $11,957.20 / $16,805.25
| Facility | | $6,266.88 | $11,957.20 | $16,805.25 |