- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,415.00 / $16,028.90 / $19,354.50
| Facility | | $8,415.00 | $16,028.90 | $19,354.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $14,473.80 / $24,690.53
| Facility | | $6,916.00 | $14,473.80 | $24,690.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,568.60 / $13,822.40 / $16,526.90
| Facility | | $11,568.60 | $13,822.40 | $16,526.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,596.09 / $11,253.51 / $14,907.20
| Facility | | $7,596.09 | $11,253.51 | $14,907.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,525.29 / $14,324.62 / $21,905.64
| Facility | | $8,525.29 | $14,324.62 | $21,905.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,363.17 / $12,727.65 / $16,744.97
| Facility | | $9,363.17 | $12,727.65 | $16,744.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,197.41 / $19,011.16
| Facility | | $3,775.00 | $13,197.41 | $19,011.16 |