- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,486.25 / $14,259.80 / $17,218.40
| Facility | | $7,486.25 | $14,259.80 | $17,218.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $12,876.35 / $20,614.61
| Facility | | $6,916.00 | $12,876.35 | $20,614.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,851.40 / $12,396.40 / $15,153.82
| Facility | | $9,851.40 | $12,396.40 | $15,153.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,093.60 / $8,409.90 / $12,392.91
| Facility | | $6,093.60 | $8,409.90 | $12,392.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,988.00 / $12,071.30 / $17,397.72
| Facility | | $7,988.00 | $12,071.30 | $17,397.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,817.50 / $10,011.02 / $13,418.76
| Facility | | $7,817.50 | $10,011.02 | $13,418.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $11,740.84 / $16,912.93
| Facility | | $3,775.00 | $11,740.84 | $16,912.93 |