- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,056.38 / $16,706.00 / $21,812.10
| Facility | | $8,056.38 | $16,706.00 | $21,812.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,059.00 / $40,852.69
| Facility | | $5,840.42 | $15,059.00 | $40,852.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,153.20 / $14,833.04 / $21,640.75
| Facility | | $10,153.20 | $14,833.04 | $21,640.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,165.49 / $22,165.49 / $22,165.49
| Facility | | $22,165.49 | $22,165.49 | $22,165.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,600.43 / $15,724.02 / $24,281.59
| Facility | | $13,600.43 | $15,724.02 | $24,281.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,059.00 / $40,852.69
| Facility | | $5,840.42 | $15,059.00 | $40,852.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,864.50 / $31,926.74
| Facility | | $5,840.42 | $11,864.50 | $31,926.74 |