- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,399.04 / $14,289.50 / $21,783.50
| Facility | | $8,399.04 | $14,289.50 | $21,783.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,366.75 / $14,863.16 / $23,376.91
| Facility | | $9,366.75 | $14,863.16 | $23,376.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,732.45 / $13,839.63 / $24,622.89
| Facility | | $8,732.45 | $13,839.63 | $24,622.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,557.02 / $13,057.67 / $29,116.61
| Facility | | $5,557.02 | $13,057.67 | $29,116.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,264.00 / $13,057.67 / $26,877.49
| Facility | | $5,264.00 | $13,057.67 | $26,877.49 |