- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,627.32 / $11,070.30 / $18,379.30
| Facility | | $8,627.32 | $11,070.30 | $18,379.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,181.59 / $7,181.59 / $9,186.62
| Facility | | $7,181.59 | $7,181.59 | $9,186.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,885.45 / $10,540.53 / $17,815.05
| Facility | | $6,885.45 | $10,540.53 | $17,815.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,542.25 / $12,079.00 / $17,817.00
| Facility | | $9,542.25 | $12,079.00 | $17,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,931.88 / $11,854.26 / $30,789.00
| Facility | | $5,931.88 | $11,854.26 | $30,789.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,931.88 / $11,318.02 / $15,906.92
| Facility | | $5,931.88 | $11,318.02 | $15,906.92 |