- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,874.56 / $15,376.20 / $20,997.60
| Facility | | $8,874.56 | $15,376.20 | $20,997.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $17,635.00 / $24,786.77
| Facility | | $8,639.91 | $17,635.00 | $24,786.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,231.26 / $14,671.80 / $21,156.55
| Facility | | $8,231.26 | $14,671.80 | $21,156.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,497.56 / $15,497.56 / $18,818.46
| Facility | | $15,497.56 | $15,497.56 | $18,818.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,543.10 / $12,104.11 / $29,367.94
| Facility | | $10,543.10 | $12,104.11 | $29,367.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,481.43 / $15,376.20 / $20,997.60
| Facility | | $8,481.43 | $15,376.20 | $20,997.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,745.02 / $13,759.52 / $19,825.74
| Facility | | $7,745.02 | $13,759.52 | $19,825.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $7,347.36 / $10,141.95
| Facility | | $2,621.40 | $7,347.36 | $10,141.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.80 / $11,855.00 / $21,503.59
| Facility | | $5,266.80 | $11,855.00 | $21,503.59 |