- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,648.09 / $14,983.90 / $20,461.80
| Facility | | $8,648.09 | $14,983.90 | $20,461.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $16,517.00 / $24,621.14
| Facility | | $8,639.91 | $16,517.00 | $24,621.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,021.21 / $14,297.40 / $20,616.66
| Facility | | $8,021.21 | $14,297.40 | $20,616.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,102.09 / $15,102.09 / $18,338.25
| Facility | | $15,102.09 | $15,102.09 | $18,338.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,517.06 / $15,501.75 / $21,175.98
| Facility | | $11,517.06 | $15,501.75 | $21,175.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,265.00 / $14,983.90 / $20,461.80
| Facility | | $8,265.00 | $14,983.90 | $20,461.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,547.38 / $13,408.40 / $19,680.29
| Facility | | $7,547.38 | $13,408.40 | $19,680.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $7,513.94 / $10,376.48
| Facility | | $2,621.40 | $7,513.94 | $10,376.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,132.39 / $11,552.48 / $20,954.86
| Facility | | $5,132.39 | $11,552.48 | $20,954.86 |