- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $16,218.10 / $22,908.68
| Facility | | $9,120.11 | $16,218.10 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,595.87 / $21,379.62
| Facility | | $10,715.19 | $16,595.87 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $15,135.61 / $20,892.96
| Facility | | $8,709.64 | $15,135.61 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $17,782.79 / $21,379.62
| Facility | | $17,782.79 | $17,782.79 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $16,595.87 / $21,379.62
| Facility | | $4,265.80 | $16,595.87 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $16,595.87 / $20,417.38
| Facility | | $7,762.47 | $16,595.87 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $15,135.61 / $22,387.21
| Facility | | $9,120.11 | $15,135.61 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $7,943.28 / $11,220.18
| Facility | | $6,918.31 | $7,943.28 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $11,220.18 / $20,892.96
| Facility | | $4,466.84 | $11,220.18 | $20,892.96 |