- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,760.60 / $15,567.90 / $27,415.20
| Facility | | $9,760.60 | $15,567.90 | $27,415.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $13,114.06 / $19,078.30
| Facility | | $6,600.00 | $13,114.06 | $19,078.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,025.26 / $12,104.91 / $20,278.55
| Facility | | $9,025.26 | $12,104.91 | $20,278.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,800.61 / $11,254.65 / $14,593.34
| Facility | | $7,800.61 | $11,254.65 | $14,593.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,590.99 / $11,602.14 / $17,854.62
| Facility | | $5,590.99 | $11,602.14 | $17,854.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,021.78 / $12,637.12 / $17,180.84
| Facility | | $9,021.78 | $12,637.12 | $17,180.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,771.00 / $9,751.18 / $25,402.08
| Facility | | $3,771.00 | $9,751.18 | $25,402.08 |