- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,421.41 / $12,858.50 / $17,559.40
| Facility | | $7,421.41 | $12,858.50 | $17,559.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,459.92 / $12,958.79 / $20,946.00
| Facility | | $8,459.92 | $12,958.79 | $20,946.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,811.88 / $12,057.05 / $17,498.05
| Facility | | $6,811.88 | $12,057.05 | $17,498.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,959.95 / $12,959.95 / $15,737.08
| Facility | | $12,959.95 | $12,959.95 | $15,737.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,961.72 / $14,874.08 / $20,170.79
| Facility | | $10,961.72 | $14,874.08 | $20,170.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,092.66 / $12,584.00 / $17,376.90
| Facility | | $7,092.66 | $12,584.00 | $17,376.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,476.83 / $10,633.48 / $16,397.74
| Facility | | $6,476.83 | $10,633.48 | $16,397.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $6,310.38 / $8,642.62
| Facility | | $2,621.40 | $6,310.38 | $8,642.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,404.39 / $9,835.18 / $17,982.54
| Facility | | $4,404.39 | $9,835.18 | $17,982.54 |