- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $9,332.54 / $13,803.84
| Facility | | $5,248.07 | $9,332.54 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $15,135.61 / $28,840.32
| Facility | | $9,772.37 | $15,135.61 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $8,912.51 / $14,791.08
| Facility | | $5,128.61 | $8,912.51 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $9,772.37 / $12,022.64
| Facility | | $9,772.37 | $9,772.37 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $9,772.37 / $12,589.25
| Facility | | $4,897.79 | $9,772.37 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $7,585.78 / $11,748.98
| Facility | | $4,786.30 | $7,585.78 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $9,120.11 / $13,489.63
| Facility | | $5,011.87 | $9,120.11 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $4,897.79 / $8,128.31
| Facility | | $4,073.80 | $4,897.79 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $6,760.83 / $11,748.98
| Facility | | $3,090.30 | $6,760.83 | $11,748.98 |