- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,962.62 / $16,008.90 / $21,861.60
| Facility | | $8,962.62 | $16,008.90 | $21,861.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $16,493.87 / $25,966.00
| Facility | | $8,639.91 | $16,493.87 | $25,966.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,480.85 / $15,011.14 / $21,785.24
| Facility | | $8,480.85 | $15,011.14 | $21,785.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,135.26 / $16,135.26 / $19,592.81
| Facility | | $16,135.26 | $16,135.26 | $19,592.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.73 / $21,571.73 / $35,936.19
| Facility | | $21,571.73 | $21,571.73 | $35,936.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,830.43 / $15,667.20 / $21,634.40
| Facility | | $8,830.43 | $15,667.20 | $21,634.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,063.71 / $13,238.78 / $20,415.34
| Facility | | $8,063.71 | $13,238.78 | $20,415.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $7,414.94 / $10,239.77
| Facility | | $2,621.40 | $7,414.94 | $10,239.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $12,342.82 / $22,388.43
| Facility | | $5,404.00 | $12,342.82 | $22,388.43 |