- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,651.22 / $9,791.42 / $13,371.00
| Facility | | $5,651.22 | $9,791.42 | $13,371.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,047.00 / $10,583.72 / $14,151.00
| Facility | | $7,047.00 | $10,583.72 | $14,151.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,241.57 / $9,342.84 / $14,496.37
| Facility | | $5,241.57 | $9,342.84 | $14,496.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,868.67 / $9,868.67 / $11,983.39
| Facility | | $9,868.67 | $9,868.67 | $11,983.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,400.88 / $9,873.46 / $13,232.10
| Facility | | $5,400.88 | $9,873.46 | $13,232.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,931.93 / $8,761.91 / $12,624.81
| Facility | | $4,931.93 | $8,761.91 | $12,624.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $4,693.25 / $6,238.56
| Facility | | $2,621.40 | $4,693.25 | $6,238.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,786.00 / $8,621.76 / $15,620.51
| Facility | | $3,786.00 | $8,621.76 | $15,620.51 |