- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,822.50 / $18,709.90 / $22,591.80
| Facility | | $9,822.50 | $18,709.90 | $22,591.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $16,894.70 / $24,907.18
| Facility | | $6,916.00 | $16,894.70 | $24,907.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,530.00 / $16,077.42 / $19,831.16
| Facility | | $10,530.00 | $16,077.42 | $19,831.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,750.96 / $11,296.25 / $15,699.15
| Facility | | $8,750.96 | $11,296.25 | $15,699.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,598.61 / $15,391.02 / $23,495.42
| Facility | | $8,598.61 | $15,391.02 | $23,495.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,445.33 / $13,494.99 / $17,109.04
| Facility | | $9,445.33 | $13,494.99 | $17,109.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,404.82 / $22,190.99
| Facility | | $3,775.00 | $15,404.82 | $22,190.99 |