- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $13,182.57 / $19,054.61
| Facility | | $7,585.78 | $13,182.57 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $14,125.38 / $22,908.68
| Facility | | $8,511.38 | $14,125.38 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $12,882.50 / $21,379.62
| Facility | | $7,079.46 | $12,882.50 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $17,378.01
| Facility | | $14,125.38 | $14,125.38 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $14,125.38 / $17,782.79
| Facility | | $6,165.95 | $14,125.38 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $13,489.63 / $17,378.01
| Facility | | $10,964.78 | $13,489.63 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $12,589.25 / $18,620.87
| Facility | | $7,244.36 | $12,589.25 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $6,918.31 / $11,481.54
| Facility | | $5,754.40 | $6,918.31 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $9,772.37 / $16,982.44
| Facility | | $3,801.89 | $9,772.37 | $16,982.44 |