- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,970.26 / $15,902.30 / $28,004.00
| Facility | | $9,970.26 | $15,902.30 | $28,004.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $13,463.68 / $19,572.33
| Facility | | $6,600.00 | $13,463.68 | $19,572.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,219.12 / $12,364.92 / $20,714.13
| Facility | | $9,219.12 | $12,364.92 | $20,714.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,002.60 / $11,701.80 / $14,934.54
| Facility | | $8,002.60 | $11,701.80 | $14,934.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,735.77 / $12,056.69 / $18,316.97
| Facility | | $5,735.77 | $12,056.69 | $18,316.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,255.40 / $12,964.36 / $17,625.75
| Facility | | $9,255.40 | $12,964.36 | $17,625.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $9,960.62 / $25,947.71
| Facility | | $3,775.00 | $9,960.62 | $25,947.71 |