- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $11,748.98 / $16,595.87
| Facility | | $6,606.93 | $11,748.98 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $13,803.84 / $22,908.68
| Facility | | $8,511.38 | $13,803.84 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $11,481.54 / $19,054.61
| Facility | | $6,456.54 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $15,135.61
| Facility | | $12,589.25 | $12,589.25 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $11,748.98 / $15,848.93
| Facility | | $5,128.61 | $11,748.98 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $12,882.50 / $17,782.79
| Facility | | $7,943.28 | $12,882.50 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $11,748.98 / $16,595.87
| Facility | | $6,456.54 | $11,748.98 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $6,165.95 / $9,772.37
| Facility | | $4,897.79 | $6,165.95 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $8,511.38 / $15,135.61
| Facility | | $3,801.89 | $8,511.38 | $15,135.61 |