- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,553.06 / $13,491.20 / $18,980.00
| Facility | | $7,553.06 | $13,491.20 | $18,980.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $16,353.06 / $24,108.00
| Facility | | $8,639.91 | $16,353.06 | $24,108.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,222.15 / $12,650.32 / $18,562.87
| Facility | | $7,222.15 | $12,650.32 | $18,562.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,597.65 / $13,597.65 / $16,511.43
| Facility | | $13,597.65 | $13,597.65 | $16,511.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.58 / $17,517.09 / $27,468.62
| Facility | | $6,289.58 | $17,517.09 | $27,468.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,441.65 / $13,491.20 / $18,959.80
| Facility | | $7,441.65 | $13,491.20 | $18,959.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,795.52 / $11,156.70 / $18,562.87
| Facility | | $6,795.52 | $11,156.70 | $18,562.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $7,380.50 / $10,190.87
| Facility | | $2,621.40 | $7,380.50 | $10,190.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,771.16 / $10,542.76 / $17,349.83
| Facility | | $3,771.16 | $10,542.76 | $17,349.83 |