- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.96 / $12,552.80 / $17,141.90
| Facility | | $7,244.96 | $12,552.80 | $17,141.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,351.00 / $13,203.05 / $20,946.00
| Facility | | $8,351.00 | $13,203.05 | $20,946.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,649.92 / $11,770.37 / $17,271.66
| Facility | | $6,649.92 | $11,770.37 | $17,271.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,651.81 / $12,651.81 / $15,362.91
| Facility | | $12,651.81 | $12,651.81 | $15,362.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,534.44 / $14,430.93 / $21,219.10
| Facility | | $9,534.44 | $14,430.93 | $21,219.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,924.02 / $12,284.80 / $16,963.80
| Facility | | $6,924.02 | $12,284.80 | $16,963.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,322.83 / $10,380.66 / $17,271.66
| Facility | | $6,322.83 | $10,380.66 | $17,271.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $6,692.60 / $9,177.23
| Facility | | $2,621.40 | $6,692.60 | $9,177.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,543.85 / $9,678.12 / $17,554.98
| Facility | | $4,543.85 | $9,678.12 | $17,554.98 |