- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,235.64 / $14,303.20 / $16,178.90
| Facility | | $9,235.64 | $14,303.20 | $16,178.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,219.76 / $15,457.10 / $20,875.97
| Facility | | $10,219.76 | $15,457.10 | $20,875.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,528.44 / $13,400.00 / $18,198.14
| Facility | | $8,528.44 | $13,400.00 | $18,198.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,874.00 / $15,678.80 / $19,893.00
| Facility | | $9,874.00 | $15,678.80 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,158.00 / $14,115.87 / $21,990.75
| Facility | | $4,158.00 | $14,115.87 | $21,990.75 |