- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,110.89 / $16,517.40 / $23,212.70
| Facility | | $9,110.89 | $16,517.40 | $23,212.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,989.87 / $10,989.87 / $10,989.87
| Facility | | $10,989.87 | $10,989.87 | $10,989.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,682.00 / $20,385.41 / $27,645.84
| Facility | | $8,682.00 | $20,385.41 | $27,645.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,842.15 / $15,487.90 / $21,852.79
| Facility | | $8,842.15 | $15,487.90 | $21,852.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,647.72 / $16,647.72 / $20,215.09
| Facility | | $16,647.72 | $16,647.72 | $20,215.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,000.51 / $18,893.68 / $30,597.38
| Facility | | $13,000.51 | $18,893.68 | $30,597.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,094.71 / $16,517.40 / $22,724.00
| Facility | | $9,094.71 | $16,517.40 | $22,724.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,319.82 / $13,639.05 / $21,297.12
| Facility | | $8,319.82 | $13,639.05 | $21,297.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $8,162.26 / $11,303.43
| Facility | | $2,621.40 | $8,162.26 | $11,303.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $12,734.83 / $23,099.50
| Facility | | $5,404.00 | $12,734.83 | $23,099.50 |