- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,135.61 / $23,988.33
| Facility | | $10,964.78 | $15,135.61 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,182.57 / $19,952.62
| Facility | | $8,912.51 | $13,182.57 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $13,182.57 / $22,908.68
| Facility | | $8,709.64 | $13,182.57 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $12,302.69 / $21,379.62
| Facility | | $6,918.31 | $12,302.69 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,000.00 / $16,982.44
| Facility | | $6,456.54 | $10,000.00 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $16,218.10 / $22,908.68
| Facility | | $7,079.46 | $16,218.10 | $22,908.68 |