- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $13,489.63 / $15,488.17
| Facility | | $8,511.38 | $13,489.63 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,454.40 / $19,054.61
| Facility | | $9,549.93 | $14,454.40 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,882.50 / $16,982.44
| Facility | | $8,128.31 | $12,882.50 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $14,791.08 / $19,952.62
| Facility | | $10,000.00 | $14,791.08 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $13,803.84 / $20,417.38
| Facility | | $4,073.80 | $13,803.84 | $20,417.38 |