- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,270.08 / $10,611.90 / $17,618.30
| Facility | | $8,270.08 | $10,611.90 | $17,618.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,976.00 / $8,284.66 / $8,964.00
| Facility | | $5,976.00 | $8,284.66 | $8,964.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,541.87 / $9,800.11 / $16,601.59
| Facility | | $6,541.87 | $9,800.11 | $16,601.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,147.12 / $11,318.82 / $16,275.08
| Facility | | $9,147.12 | $11,318.82 | $16,275.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,686.25 / $11,363.40 / $29,252.66
| Facility | | $5,686.25 | $11,363.40 | $29,252.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,686.25 / $10,849.37 / $15,248.25
| Facility | | $5,686.25 | $10,849.37 | $15,248.25 |