- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,593.42 / $11,088.60 / $14,574.30
| Facility | | $7,593.42 | $11,088.60 | $14,574.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,981.25 / $8,981.25 / $14,197.34
| Facility | | $8,981.25 | $8,981.25 | $14,197.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,594.84 / $17,960.24 / $30,377.33
| Facility | | $6,594.84 | $17,960.24 | $30,377.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,992.42 / $11,227.58 / $18,642.37
| Facility | | $7,992.42 | $11,227.58 | $18,642.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,551.49 / $12,430.07 / $18,148.91
| Facility | | $9,551.49 | $12,430.07 | $18,148.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,333.44 / $10,614.36 / $18,148.91
| Facility | | $6,333.44 | $10,614.36 | $18,148.91 |