- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,832.82 / $13,571.30 / $19,396.09
| Facility | | $7,832.82 | $13,571.30 | $19,396.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,459.92 / $12,821.70 / $20,946.00
| Facility | | $8,459.92 | $12,821.70 | $20,946.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,835.87 / $12,725.43 / $18,468.06
| Facility | | $6,835.87 | $12,725.43 | $18,468.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,678.39 / $13,678.39 / $16,609.47
| Facility | | $13,678.39 | $13,678.39 | $16,609.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,144.49 / $15,292.16 / $21,723.94
| Facility | | $9,144.49 | $15,292.16 | $21,723.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,485.84 / $13,571.30 / $18,532.80
| Facility | | $7,485.84 | $13,571.30 | $18,532.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,560.00 / $11,222.95 / $17,593.37
| Facility | | $6,560.00 | $11,222.95 | $17,593.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $6,760.56 / $9,276.15
| Facility | | $2,621.40 | $6,760.56 | $9,276.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,648.56 / $10,463.41 / $18,979.41
| Facility | | $4,648.56 | $10,463.41 | $18,979.41 |