- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $12,022.64 / $19,498.45
| Facility | | $11,220.18 | $12,022.64 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,803.84 / $20,417.38
| Facility | | $9,549.93 | $13,803.84 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $16,595.87 / $29,512.09
| Facility | | $9,549.93 | $16,595.87 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $15,848.93 / $19,054.61
| Facility | | $12,589.25 | $15,848.93 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $15,135.61 / $23,988.33
| Facility | | $7,585.78 | $15,135.61 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $7,943.28 / $10,471.29
| Facility | | $5,754.40 | $7,943.28 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.90 / $12,302.69 / $15,848.93
| Facility | | $134.90 | $12,302.69 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $14,454.40 / $22,387.21
| Facility | | $12,022.64 | $14,454.40 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,488.17 / $24,547.09
| Facility | | $10,964.78 | $15,488.17 | $24,547.09 |