- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,427.50 / $16,052.70 / $19,383.30
| Facility | | $8,427.50 | $16,052.70 | $19,383.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $14,495.30 / $23,401.66
| Facility | | $6,916.00 | $14,495.30 | $23,401.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,991.43 / $13,787.17 / $17,583.63
| Facility | | $8,991.43 | $13,787.17 | $17,583.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,500.00 / $10,919.10 / $59,999.40
| Facility | | $4,500.00 | $10,919.10 | $59,999.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,988.00 / $14,067.59 / $21,919.05
| Facility | | $7,988.00 | $14,067.59 | $21,919.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,874.40 / $12,299.89 / $15,637.88
| Facility | | $8,874.40 | $12,299.89 | $15,637.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,135.60 / $18,083.39
| Facility | | $3,775.00 | $12,135.60 | $18,083.39 |