- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,744.79 / $14,927.00 / $24,262.70
| Facility | | $8,744.79 | $14,927.00 | $24,262.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,189.06 / $14,189.06 / $14,189.06
| Facility | | $14,189.06 | $14,189.06 | $14,189.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,543.73 / $11,860.27 / $18,710.73
| Facility | | $7,543.73 | $11,860.27 | $18,710.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,952.15 / $12,547.11 / $23,109.63
| Facility | | $6,952.15 | $12,547.11 | $23,109.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,201.58 / $12,560.72 / $17,058.45
| Facility | | $6,201.58 | $12,560.72 | $17,058.45 |