- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,545.31 / $11,691.20 / $15,965.30
| Facility | | $6,545.31 | $11,691.20 | $15,965.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,459.92 / $13,239.09 / $19,824.00
| Facility | | $8,459.92 | $13,239.09 | $19,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,258.56 / $11,155.56 / $16,661.00
| Facility | | $6,258.56 | $11,155.56 | $16,661.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,783.42 / $11,783.42 / $14,308.44
| Facility | | $11,783.42 | $11,783.42 | $14,308.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,727.53 / $10,655.20 / $18,413.03
| Facility | | $7,727.53 | $10,655.20 | $18,413.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,448.77 / $11,691.20 / $15,965.30
| Facility | | $6,448.77 | $11,691.20 | $15,965.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.85 / $10,461.91 / $15,628.00
| Facility | | $5,888.85 | $10,461.91 | $15,628.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $5,572.66 / $7,523.39
| Facility | | $2,621.40 | $5,572.66 | $7,523.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,324.21 / $9,013.84 / $16,350.05
| Facility | | $4,324.21 | $9,013.84 | $16,350.05 |