- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,122.42 / $12,912.40 / $18,613.00
| Facility | | $7,122.42 | $12,912.40 | $18,613.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,534.00 / $16,489.09 / $22,313.25
| Facility | | $8,534.00 | $16,489.09 | $22,313.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,912.33 / $12,320.88 / $17,766.55
| Facility | | $6,912.33 | $12,320.88 | $17,766.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,014.32 / $13,014.32 / $15,803.11
| Facility | | $13,014.32 | $13,014.32 | $15,803.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,728.77 / $11,333.42 / $15,998.10
| Facility | | $5,728.77 | $11,333.42 | $15,998.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,109.78 / $12,912.40 / $18,513.00
| Facility | | $7,109.78 | $12,912.40 | $18,513.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,504.00 / $11,554.77 / $16,897.73
| Facility | | $6,504.00 | $11,554.77 | $16,897.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $6,498.08 / $8,910.48
| Facility | | $2,621.40 | $6,498.08 | $8,910.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,775.92 / $9,955.43 / $18,057.99
| Facility | | $4,775.92 | $9,955.43 | $18,057.99 |