- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $19,054.61 / $26,915.35
| Facility | | $10,715.19 | $19,054.61 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $21,877.62 / $30,199.52
| Facility | | $13,803.84 | $21,877.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $17,782.79 / $28,183.83
| Facility | | $10,232.93 | $17,782.79 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $20,417.38 / $25,118.86
| Facility | | $20,417.38 | $20,417.38 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $19,952.62 / $24,547.09
| Facility | | $8,511.38 | $19,952.62 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $21,379.62 / $32,359.37
| Facility | | $9,332.54 | $21,379.62 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $18,197.01 / $26,915.35
| Facility | | $10,471.29 | $18,197.01 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $10,000.00 / $16,595.87
| Facility | | $8,317.64 | $10,000.00 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $13,803.84 / $24,547.09
| Facility | | $4,897.79 | $13,803.84 | $24,547.09 |