- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,040.79 / $14,997.20 / $20,125.00
| Facility | | $9,040.79 | $14,997.20 | $20,125.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,234.07 / $8,262.08 / $18,786.91
| Facility | | $8,234.07 | $8,262.08 | $18,786.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,574.03 / $12,900.05 / $20,348.65
| Facility | | $7,574.03 | $12,900.05 | $20,348.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,423.71 / $12,075.00 / $27,692.81
| Facility | | $7,423.71 | $12,075.00 | $27,692.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,813.95 / $11,850.41 / $16,850.25
| Facility | | $8,813.95 | $11,850.41 | $16,850.25 |