- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,001.62 / $10,720.00 / $14,639.20
| Facility | | $6,001.62 | $10,720.00 | $14,639.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,934.00 / $11,956.10 / $19,753.79
| Facility | | $7,934.00 | $11,956.10 | $19,753.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,738.69 / $10,228.92 / $15,628.00
| Facility | | $5,738.69 | $10,228.92 | $15,628.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,804.62 / $10,804.62 / $13,119.90
| Facility | | $10,804.62 | $10,804.62 | $13,119.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,913.10 / $10,507.00 / $14,639.20
| Facility | | $5,913.10 | $10,507.00 | $14,639.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,399.69 / $9,592.89 / $15,358.89
| Facility | | $5,399.69 | $9,592.89 | $15,358.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $5,942.21 / $8,098.01
| Facility | | $2,621.40 | $5,942.21 | $8,098.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,965.02 / $8,265.10 / $14,991.92
| Facility | | $3,965.02 | $8,265.10 | $14,991.92 |