- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,009.56 / $13,953.10 / $15,782.80
| Facility | | $9,009.56 | $13,953.10 | $15,782.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,078.41 / $13,730.84 / $18,544.53
| Facility | | $9,078.41 | $13,730.84 | $18,544.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,319.68 / $12,838.14 / $17,495.07
| Facility | | $8,319.68 | $12,838.14 | $17,495.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,930.00 / $14,648.00 / $19,893.00
| Facility | | $9,930.00 | $14,648.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,118.52 / $21,400.93
| Facility | | $5,274.00 | $16,118.52 | $21,400.93 |