- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,469.03 / $13,414.40 / $17,514.40
| Facility | | $6,469.03 | $13,414.40 | $17,514.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.00 / $12,091.91 / $32,803.47
| Facility | | $2,503.00 | $12,091.91 | $32,803.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,579.61 / $12,533.04 / $18,937.58
| Facility | | $7,579.61 | $12,533.04 | $18,937.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,798.21 / $17,798.21 / $17,798.21
| Facility | | $17,798.21 | $17,798.21 | $17,798.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,920.73 / $12,625.91 / $19,497.37
| Facility | | $10,920.73 | $12,625.91 | $19,497.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.00 / $12,091.91 / $32,803.47
| Facility | | $2,503.00 | $12,091.91 | $32,803.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.00 / $12,091.91 / $25,636.20
| Facility | | $2,503.00 | $12,091.91 | $25,636.20 |