- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,752.66 / $10,275.29 / $14,974.60
| Facility | | $5,752.66 | $10,275.29 | $14,974.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,507.00 / $13,020.40 / $19,681.00
| Facility | | $8,507.00 | $13,020.40 | $19,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,500.63 / $9,634.91 / $15,212.84
| Facility | | $5,500.63 | $9,634.91 | $15,212.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,356.42 / $10,356.42 / $12,575.66
| Facility | | $10,356.42 | $10,356.42 | $12,575.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,955.26 / $9,565.70 / $13,565.88
| Facility | | $4,955.26 | $9,565.70 | $13,565.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,667.81 / $10,275.29 / $14,960.00
| Facility | | $5,667.81 | $10,275.29 | $14,960.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,175.70 / $8,497.32 / $13,248.78
| Facility | | $5,175.70 | $8,497.32 | $13,248.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $5,149.72 / $6,922.10
| Facility | | $2,621.40 | $5,149.72 | $6,922.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.54 / $7,922.24 / $14,370.02
| Facility | | $3,800.54 | $7,922.24 | $14,370.02 |