- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,794.62 / $17,641.70 / $25,816.20
| Facility | | $9,794.62 | $17,641.70 | $25,816.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,588.00 / $20,044.56 / $29,127.00
| Facility | | $9,588.00 | $20,044.56 | $29,127.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,365.52 / $16,200.24 / $23,807.58
| Facility | | $9,365.52 | $16,200.24 | $23,807.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,633.11 / $17,633.11 / $21,411.63
| Facility | | $17,633.11 | $17,633.11 | $21,411.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,402.20 / $17,721.25 / $27,307.65
| Facility | | $11,402.20 | $17,721.25 | $27,307.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,650.16 / $17,641.70 / $24,835.00
| Facility | | $9,650.16 | $17,641.70 | $24,835.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,812.27 / $15,502.00 / $22,970.88
| Facility | | $8,812.27 | $15,502.00 | $22,970.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $8,738.70 / $12,110.34
| Facility | | $2,621.40 | $8,738.70 | $12,110.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $14,734.21 / $24,466.77
| Facility | | $5,404.00 | $14,734.21 | $24,466.77 |