- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,542.00 / $13,565.80 / $17,712.00
| Facility | | $6,542.00 | $13,565.80 | $17,712.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,228.32 / $33,173.50
| Facility | | $5,840.42 | $12,228.32 | $33,173.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,665.11 / $12,674.42 / $19,151.20
| Facility | | $7,665.11 | $12,674.42 | $19,151.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,998.98 / $17,998.98 / $17,998.98
| Facility | | $17,998.98 | $17,998.98 | $17,998.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,043.92 / $12,768.34 / $19,717.31
| Facility | | $11,043.92 | $12,768.34 | $19,717.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,228.32 / $33,173.50
| Facility | | $5,840.42 | $12,228.32 | $33,173.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $25,925.38
| Facility | | $5,840.42 | $9,750.00 | $25,925.38 |