- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,019.40 / $19,092.40 / $26,072.30
| Facility | | $11,019.40 | $19,092.40 | $26,072.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,868.00 / $17,697.16 / $27,062.32
| Facility | | $8,868.00 | $17,697.16 | $27,062.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,616.83 / $17,902.37 / $25,981.21
| Facility | | $9,616.83 | $17,902.37 | $25,981.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,243.00 / $19,243.00 / $23,366.51
| Facility | | $19,243.00 | $19,243.00 | $23,366.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.26 / $18,733.23 / $21,849.74
| Facility | | $13,803.26 | $18,733.23 | $21,849.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,531.20 / $18,684.80 / $25,801.40
| Facility | | $10,531.20 | $18,684.80 | $25,801.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,919.94 / $15,788.66 / $24,347.46
| Facility | | $8,919.94 | $15,788.66 | $24,347.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $8,835.15 / $12,253.71
| Facility | | $2,621.40 | $8,835.15 | $12,253.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,431.44 / $14,720.12 / $26,700.58
| Facility | | $5,431.44 | $14,720.12 | $26,700.58 |