- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,938.75 / $17,026.50 / $20,559.09
| Facility | | $8,938.75 | $17,026.50 | $20,559.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $15,374.65 / $24,863.11
| Facility | | $6,916.00 | $15,374.65 | $24,863.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,972.46 / $14,682.72 / $18,455.06
| Facility | | $12,972.46 | $14,682.72 | $18,455.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,708.58 / $11,984.67 / $15,623.10
| Facility | | $8,708.58 | $11,984.67 | $15,623.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,581.20 / $15,418.50 / $23,583.96
| Facility | | $8,581.20 | $15,418.50 | $23,583.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,428.62 / $13,239.34 / $18,027.90
| Facility | | $9,428.62 | $13,239.34 | $18,027.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,018.82 / $20,194.41
| Facility | | $3,775.00 | $14,018.82 | $20,194.41 |