- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,306.00 / $17,856.40 / $24,384.50
| Facility | | $10,306.00 | $17,856.40 | $24,384.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,480.00 / $19,206.93 / $29,127.00
| Facility | | $9,480.00 | $19,206.93 | $29,127.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,558.93 / $17,038.32 / $25,432.00
| Facility | | $9,558.93 | $17,038.32 | $25,432.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,997.27 / $17,997.27 / $21,853.83
| Facility | | $17,997.27 | $17,997.27 | $21,853.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,849.45 / $17,856.40 / $24,384.50
| Facility | | $9,849.45 | $17,856.40 | $24,384.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,994.27 / $14,766.54 / $23,864.00
| Facility | | $8,994.27 | $14,766.54 | $23,864.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $7,192.18 / $9,913.00
| Facility | | $2,621.40 | $7,192.18 | $9,913.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $13,767.18 / $24,972.06
| Facility | | $5,404.00 | $13,767.18 | $24,972.06 |