- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,852.87 / $11,410.20 / $23,188.50
| Facility | | $8,852.87 | $11,410.20 | $23,188.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,009.65 / $12,563.78 / $15,795.63
| Facility | | $8,009.65 | $12,563.78 | $15,795.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,747.20 / $10,964.80 / $12,535.60
| Facility | | $8,747.20 | $10,964.80 | $12,535.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,066.49 / $12,508.43 / $16,267.75
| Facility | | $7,066.49 | $12,508.43 | $16,267.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,394.04 / $13,569.79 / $18,954.75
| Facility | | $9,394.04 | $13,569.79 | $18,954.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $10,031.45 / $15,448.68
| Facility | | $1,286.00 | $10,031.45 | $15,448.68 |