- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,829.61 / $11,696.00 / $20,463.59
| Facility | | $8,829.61 | $11,696.00 | $20,463.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,792.05 / $9,362.83 / $14,815.00
| Facility | | $6,792.05 | $9,362.83 | $14,815.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,786.47 / $10,300.87 / $19,347.24
| Facility | | $5,786.47 | $10,300.87 | $19,347.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,310.43 / $12,571.55 / $18,270.45
| Facility | | $8,310.43 | $12,571.55 | $18,270.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $12,053.33 / $18,409.97
| Facility | | $3,496.00 | $12,053.33 | $18,409.97 |