- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,042.06 / $10,953.80 / $14,958.40
| Facility | | $6,042.06 | $10,953.80 | $14,958.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,831.30 / $3,831.30 / $3,831.30
| Facility | | $3,831.30 | $3,831.30 | $3,831.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,021.96 / $11,763.97 / $19,155.50
| Facility | | $8,021.96 | $11,763.97 | $19,155.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,863.84 / $10,452.00 / $15,745.00
| Facility | | $5,863.84 | $10,452.00 | $15,745.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,040.26 / $11,040.26 / $13,406.03
| Facility | | $11,040.26 | $11,040.26 | $13,406.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,113.41 / $9,539.33 / $14,163.20
| Facility | | $5,113.41 | $9,539.33 | $14,163.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,031.34 / $10,720.00 / $14,958.40
| Facility | | $6,031.34 | $10,720.00 | $14,958.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,517.45 / $9,802.10 / $15,071.65
| Facility | | $5,517.45 | $9,802.10 | $15,071.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $5,699.51 / $7,739.01
| Facility | | $2,621.40 | $5,699.51 | $7,739.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,051.49 / $8,445.35 / $15,318.88
| Facility | | $4,051.49 | $8,445.35 | $15,318.88 |