- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,735.39 / $12,492.10 / $20,739.90
| Facility | | $9,735.39 | $12,492.10 | $20,739.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,504.00 / $11,229.00 / $12,035.65
| Facility | | $9,504.00 | $11,229.00 | $12,035.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,722.13 / $11,821.36 / $19,684.75
| Facility | | $7,722.13 | $11,821.36 | $19,684.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,767.83 / $13,436.00 / $19,818.00
| Facility | | $10,767.83 | $13,436.00 | $19,818.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,693.75 / $13,376.79 / $34,530.33
| Facility | | $6,693.75 | $13,376.79 | $34,530.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,693.75 / $12,771.68 / $17,949.96
| Facility | | $6,693.75 | $12,771.68 | $17,949.96 |