- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,449.95 / $13,086.40 / $14,802.50
| Facility | | $8,449.95 | $13,086.40 | $14,802.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,579.07 / $12,975.60 / $17,524.52
| Facility | | $8,579.07 | $12,975.60 | $17,524.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,802.93 / $12,149.46 / $16,507.00
| Facility | | $7,802.93 | $12,149.46 | $16,507.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,054.00 / $14,056.00 / $19,893.00
| Facility | | $10,054.00 | $14,056.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $12,893.14 / $20,120.00
| Facility | | $4,008.00 | $12,893.14 | $20,120.00 |