- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,648.52 / $15,842.00 / $22,430.60
| Facility | | $8,648.52 | $15,842.00 | $22,430.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,044.25 / $14,547.98 / $23,126.71
| Facility | | $9,044.25 | $14,547.98 | $23,126.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,991.84 / $14,250.70 / $25,354.26
| Facility | | $8,991.84 | $14,250.70 | $25,354.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,722.08 / $13,653.36 / $29,981.46
| Facility | | $5,722.08 | $13,653.36 | $29,981.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,152.61 / $26,643.09
| Facility | | $3,308.00 | $13,152.61 | $26,643.09 |