- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,527.65 / $11,063.00 / $17,080.30
| Facility | | $7,527.65 | $11,063.00 | $17,080.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,721.51 / $17,279.93 / $25,604.44
| Facility | | $15,721.51 | $17,279.93 | $25,604.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,969.52 / $14,173.16 / $18,170.72
| Facility | | $9,969.52 | $14,173.16 | $18,170.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,748.60 / $9,259.95 / $18,933.36
| Facility | | $4,748.60 | $9,259.95 | $18,933.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,527.65 / $11,315.50 / $18,094.00
| Facility | | $7,527.65 | $11,315.50 | $18,094.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,780.18 / $15,054.10 / $22,871.55
| Facility | | $7,780.18 | $15,054.10 | $22,871.55 |