- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $16,982.44 / $23,988.33
| Facility | | $9,549.93 | $16,982.44 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $18,197.01 / $28,840.32
| Facility | | $9,120.11 | $18,197.01 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $15,848.93 / $25,118.86
| Facility | | $8,912.51 | $15,848.93 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,197.01 / $18,197.01 / $21,877.62
| Facility | | $18,197.01 | $18,197.01 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $17,782.79 / $21,877.62
| Facility | | $8,128.31 | $17,782.79 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $19,952.62 / $28,840.32
| Facility | | $11,220.18 | $19,952.62 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,218.10 / $22,908.68
| Facility | | $9,332.54 | $16,218.10 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $9,120.11 / $15,135.61
| Facility | | $7,585.78 | $9,120.11 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $12,302.69 / $21,379.62
| Facility | | $4,265.80 | $12,302.69 | $21,379.62 |