- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,880.66 / $17,648.70 / $24,100.90
| Facility | | $9,880.66 | $17,648.70 | $24,100.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,899.00 / $16,995.63 / $25,930.26
| Facility | | $8,899.00 | $16,995.63 | $25,930.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,889.68 / $16,548.74 / $24,283.35
| Facility | | $8,889.68 | $16,548.74 | $24,283.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,788.00 / $17,788.00 / $21,599.72
| Facility | | $17,788.00 | $17,788.00 | $21,599.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,734.93 / $16,951.40 / $23,850.50
| Facility | | $9,734.93 | $16,951.40 | $23,850.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,245.48 / $14,594.84 / $23,069.95
| Facility | | $8,245.48 | $14,594.84 | $23,069.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $8,773.85 / $12,162.58
| Facility | | $2,621.40 | $8,773.85 | $12,162.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,524.18 / $13,702.09 / $22,696.49
| Facility | | $4,524.18 | $13,702.09 | $22,696.49 |