- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,791.53 / $14,022.30 / $24,693.30
| Facility | | $8,791.53 | $14,022.30 | $24,693.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.00 / $11,600.83 / $16,864.29
| Facility | | $5,623.00 | $11,600.83 | $16,864.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,129.20 / $10,903.09 / $18,265.22
| Facility | | $8,129.20 | $10,903.09 | $18,265.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,445.79 / $9,396.54 / $11,563.68
| Facility | | $6,445.79 | $9,396.54 | $11,563.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,350.00 / $10,422.93 / $15,782.62
| Facility | | $5,350.00 | $10,422.93 | $15,782.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,974.81 / $11,176.54 / $15,187.04
| Facility | | $7,974.81 | $11,176.54 | $15,187.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,396.60 / $8,783.04 / $22,880.06
| Facility | | $3,396.60 | $8,783.04 | $22,880.06 |