- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $8,442.00 / $14,230.00
| Facility | | $4,804.00 | $8,442.00 | $14,230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,713.00 / $9,644.28
| Facility | | $688.00 | $2,713.00 | $9,644.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,389.43 / $8,744.49 / $15,176.53
| Facility | | $5,389.43 | $8,744.49 | $15,176.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,135.90 / $18,227.71 / $18,227.71
| Facility | | $11,135.90 | $18,227.71 | $18,227.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,053.77 / $14,053.77 / $47,663.78
| Facility | | $14,053.77 | $14,053.77 | $47,663.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,521.00 / $7,846.25 / $15,176.53
| Facility | | $5,521.00 | $7,846.25 | $15,176.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,012.96 / $7,030.24 / $16,072.89
| Facility | | $3,012.96 | $7,030.24 | $16,072.89 |