- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,555.00 / $16,295.60 / $19,676.50
| Facility | | $8,555.00 | $16,295.60 | $19,676.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $14,714.60 / $25,257.78
| Facility | | $6,916.00 | $14,714.60 | $25,257.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,538.16 / $14,052.34 / $17,900.59
| Facility | | $12,538.16 | $14,052.34 | $17,900.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,555.04 / $12,097.20 / $15,655.20
| Facility | | $8,555.04 | $12,097.20 | $15,655.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,722.87 / $14,970.53 / $22,631.40
| Facility | | $8,722.87 | $14,970.53 | $22,631.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,584.58 / $13,284.19 / $17,299.75
| Facility | | $9,584.58 | $13,284.19 | $17,299.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,416.98 / $19,327.46
| Facility | | $3,775.00 | $13,416.98 | $19,327.46 |