- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,889.58 / $10,980.00 / $16,877.30
| Facility | | $7,889.58 | $10,980.00 | $16,877.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,644.31 / $8,644.31 / $8,644.31
| Facility | | $8,644.31 | $8,644.31 | $8,644.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,422.48 / $9,970.02 / $15,210.00
| Facility | | $6,422.48 | $9,970.02 | $15,210.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,882.64 / $9,654.10 / $17,198.00
| Facility | | $6,882.64 | $9,654.10 | $17,198.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $73.16 / $101.24 / $170.65
| Facility | | $73.16 | $101.24 | $170.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,193.06 / $10,477.87 / $16,632.18
| Facility | | $7,193.06 | $10,477.87 | $16,632.18 |