- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,019.62 / $13,968.70 / $15,800.50
| Facility | | $9,019.62 | $13,968.70 | $15,800.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,139.71 / $13,823.56 / $18,669.75
| Facility | | $9,139.71 | $13,823.56 | $18,669.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,328.98 / $13,159.54 / $17,772.50
| Facility | | $8,328.98 | $13,159.54 | $17,772.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,952.00 / $14,560.00 / $19,893.00
| Facility | | $9,952.00 | $14,560.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,136.54 / $21,424.85
| Facility | | $5,274.00 | $16,136.54 | $21,424.85 |