- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,638.75 / $16,455.09 / $19,869.09
| Facility | | $8,638.75 | $16,455.09 | $19,869.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $14,858.65 / $24,690.53
| Facility | | $6,916.00 | $14,858.65 | $24,690.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,550.43 / $14,189.93 / $18,021.62
| Facility | | $12,550.43 | $14,189.93 | $18,021.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,625.88 / $11,192.80 / $14,843.23
| Facility | | $7,625.88 | $11,192.80 | $14,843.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,525.29 / $14,591.08 / $21,959.25
| Facility | | $8,525.29 | $14,591.08 | $21,959.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,363.17 / $12,677.37 / $16,883.66
| Facility | | $9,363.17 | $12,677.37 | $16,883.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,548.32 / $19,516.66
| Facility | | $3,775.00 | $13,548.32 | $19,516.66 |