- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,755.59 / $11,148.50 / $18,509.09
| Facility | | $7,755.59 | $11,148.50 | $18,509.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,649.67 / $9,961.60 / $16,875.16
| Facility | | $6,649.67 | $9,961.60 | $16,875.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,609.61 / $12,421.58 / $18,208.00
| Facility | | $9,609.61 | $12,421.58 | $18,208.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,983.80 / $12,009.63 / $28,820.00
| Facility | | $7,983.80 | $12,009.63 | $28,820.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,973.75 / $12,009.63 / $20,654.84
| Facility | | $5,973.75 | $12,009.63 | $20,654.84 |