- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,372.70 / $12,026.80 / $19,967.30
| Facility | | $9,372.70 | $12,026.80 | $19,967.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,504.00 / $9,504.00 / $9,504.00
| Facility | | $9,504.00 | $9,504.00 | $9,504.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,303.44 / $11,180.41 / $18,534.25
| Facility | | $7,303.44 | $11,180.41 | $18,534.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,366.68 / $12,827.92 / $18,861.00
| Facility | | $10,366.68 | $12,827.92 | $18,861.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,444.38 / $12,878.44 / $32,658.11
| Facility | | $6,444.38 | $12,878.44 | $32,658.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,444.38 / $12,295.87 / $17,281.24
| Facility | | $6,444.38 | $12,295.87 | $17,281.24 |