- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,814.95 / $15,654.60 / $27,567.80
| Facility | | $9,814.95 | $15,654.60 | $27,567.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,600.00 / $14,407.89 / $20,507.34
| Facility | | $6,600.00 | $14,407.89 | $20,507.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,075.52 / $12,172.32 / $20,391.48
| Facility | | $9,075.52 | $12,172.32 | $20,391.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,045.21 / $11,238.70 / $14,433.02
| Facility | | $8,045.21 | $11,238.70 | $14,433.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,347.06 / $12,296.49 / $19,739.30
| Facility | | $6,347.06 | $12,296.49 | $19,739.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,241.79 / $14,040.65 / $19,249.97
| Facility | | $10,241.79 | $14,040.65 | $19,249.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $9,805.48 / $25,543.54
| Facility | | $3,775.00 | $9,805.48 | $25,543.54 |