- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $11,748.98 / $16,982.44
| Facility | | $6,606.93 | $11,748.98 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $12,589.25 / $20,892.96
| Facility | | $7,413.10 | $12,589.25 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $11,481.54 / $17,782.79
| Facility | | $6,606.93 | $11,481.54 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $15,488.17
| Facility | | $12,589.25 | $12,589.25 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $12,589.25 / $15,848.93
| Facility | | $5,495.41 | $12,589.25 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,022.64 / $16,595.87
| Facility | | $7,762.47 | $12,022.64 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,964.78 / $16,218.10
| Facility | | $6,456.54 | $10,964.78 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $6,456.54 / $10,232.93
| Facility | | $5,128.61 | $6,456.54 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $8,709.64 / $15,135.61
| Facility | | $3,630.78 | $8,709.64 | $15,135.61 |