- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,517.87 / $14,758.20 / $20,153.70
| Facility | | $8,517.87 | $14,758.20 | $20,153.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $16,595.09 / $24,512.00
| Facility | | $8,639.91 | $16,595.09 | $24,512.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,900.43 / $13,838.39 / $20,306.24
| Facility | | $7,900.43 | $13,838.39 | $20,306.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,874.69 / $14,874.69 / $18,062.12
| Facility | | $14,874.69 | $14,874.69 | $18,062.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,140.55 / $14,758.20 / $20,153.70
| Facility | | $8,140.55 | $14,758.20 | $20,153.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,433.73 / $12,204.50 / $20,306.24
| Facility | | $7,433.73 | $12,204.50 | $20,306.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $8,049.10 / $11,146.71
| Facility | | $2,621.40 | $8,049.10 | $11,146.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,783.22 / $11,566.00 / $18,979.27
| Facility | | $3,783.22 | $11,566.00 | $18,979.27 |