- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,049.37 / $12,780.00 / $17,452.20
| Facility | | $7,049.37 | $12,780.00 | $17,452.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,267.54 / $8,267.54 / $8,267.54
| Facility | | $8,267.54 | $8,267.54 | $8,267.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,459.92 / $12,843.00 / $19,801.72
| Facility | | $8,459.92 | $12,843.00 | $19,801.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,770.30 / $12,194.52 / $17,584.34
| Facility | | $6,770.30 | $12,194.52 | $17,584.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,880.85 / $12,880.85 / $15,641.04
| Facility | | $12,880.85 | $12,880.85 | $15,641.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,039.07 / $12,465.57 / $17,547.46
| Facility | | $7,039.07 | $12,465.57 | $17,547.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,036.86 / $12,507.20 / $17,452.20
| Facility | | $7,036.86 | $12,507.20 | $17,452.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,437.30 / $11,436.27 / $16,478.24
| Facility | | $6,437.30 | $11,436.27 | $16,478.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $6,338.93 / $8,684.85
| Facility | | $2,621.40 | $6,338.93 | $8,684.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,635.69 / $9,987.00 / $16,400.07
| Facility | | $3,635.69 | $9,987.00 | $16,400.07 |