- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,790.11 / $15,615.00 / $27,498.00
| Facility | | $9,790.11 | $15,615.00 | $27,498.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,532.00 / $13,283.27 / $19,310.07
| Facility | | $6,532.00 | $13,283.27 | $19,310.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,052.54 / $12,141.50 / $20,339.86
| Facility | | $9,052.54 | $12,141.50 | $20,339.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,386.42 / $10,767.78 / $13,251.16
| Facility | | $7,386.42 | $10,767.78 | $13,251.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,658.91 / $11,859.22 / $18,071.53
| Facility | | $5,658.91 | $11,859.22 | $18,071.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,131.37 / $12,790.64 / $17,389.57
| Facility | | $9,131.37 | $12,790.64 | $17,389.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $9,780.66 / $25,478.88
| Facility | | $3,775.00 | $9,780.66 | $25,478.88 |