- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,340.99 / $10,986.50 / $15,003.10
| Facility | | $6,340.99 | $10,986.50 | $15,003.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,021.96 / $10,887.17 / $18,606.00
| Facility | | $8,021.96 | $10,887.17 | $18,606.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,881.34 / $10,483.20 / $15,628.00
| Facility | | $5,881.34 | $10,483.20 | $15,628.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,073.22 / $11,073.22 / $13,446.05
| Facility | | $11,073.22 | $11,073.22 | $13,446.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,586.64 / $15,490.62 / $18,731.84
| Facility | | $4,586.64 | $15,490.62 | $18,731.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,060.10 / $10,752.00 / $15,003.10
| Facility | | $6,060.10 | $10,752.00 | $15,003.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,533.92 / $9,831.36 / $14,165.76
| Facility | | $5,533.92 | $9,831.36 | $14,165.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $5,031.70 / $6,745.38
| Facility | | $2,621.40 | $5,031.70 | $6,745.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,063.58 / $8,470.56 / $15,364.61
| Facility | | $4,063.58 | $8,470.56 | $15,364.61 |