- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,176.10 / $14,148.80 / $18,346.50
| Facility | | $9,176.10 | $14,148.80 | $18,346.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,107.65 / $14,073.00 / $19,062.41
| Facility | | $8,107.65 | $14,073.00 | $19,062.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,695.00 / $11,424.00 / $17,824.00
| Facility | | $7,695.00 | $11,424.00 | $17,824.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $16,909.16 / $19,529.00
| Facility | | $6,098.00 | $16,909.16 | $19,529.00 |