- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,261.73 / $10,849.20 / $15,246.90
| Facility | | $6,261.73 | $10,849.20 | $15,246.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,503.00 / $13,420.12 / $19,364.00
| Facility | | $8,503.00 | $13,420.12 | $19,364.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,807.83 / $10,352.16 / $15,628.00
| Facility | | $5,807.83 | $10,352.16 | $15,628.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,934.80 / $10,934.80 / $13,277.97
| Facility | | $10,934.80 | $10,934.80 | $13,277.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,532.18 / $11,597.25 / $14,934.55
| Facility | | $8,532.18 | $11,597.25 | $14,934.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,984.35 / $10,849.20 / $14,815.50
| Facility | | $5,984.35 | $10,849.20 | $14,815.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,464.75 / $9,708.46 / $14,927.68
| Facility | | $5,464.75 | $9,708.46 | $14,927.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $5,276.64 / $7,112.16
| Facility | | $2,621.40 | $5,276.64 | $7,112.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,012.79 / $8,364.68 / $15,172.55
| Facility | | $4,012.79 | $8,364.68 | $15,172.55 |