- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,783.02 / $10,739.30 / $17,973.80
| Facility | | $7,783.02 | $10,739.30 | $17,973.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,673.66 / $16,409.12 / $19,422.50
| Facility | | $8,673.66 | $16,409.12 | $19,422.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $12,429.45 / $18,792.68
| Facility | | $2,423.00 | $12,429.45 | $18,792.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,965.86 / $12,082.21 / $20,261.80
| Facility | | $7,965.86 | $12,082.21 | $20,261.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $9,751.01 / $21,682.51
| Facility | | $2,600.00 | $9,751.01 | $21,682.51 |