- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,802.51 / $13,626.10 / $15,420.10
| Facility | | $8,802.51 | $13,626.10 | $15,420.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,668.24 / $13,110.46 / $17,706.66
| Facility | | $8,668.24 | $13,110.46 | $17,706.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.48 / $12,543.10 / $17,093.00
| Facility | | $8,128.48 | $12,543.10 | $17,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,333.00 / $13,585.00 / $19,893.00
| Facility | | $8,333.00 | $13,585.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $12,713.77 / $20,909.09
| Facility | | $5,274.00 | $12,713.77 | $20,909.09 |