- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,450.96 / $10,855.20 / $18,003.59
| Facility | | $8,450.96 | $10,855.20 | $18,003.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,163.34 / $10,423.41 / $22,802.38
| Facility | | $7,163.34 | $10,423.41 | $22,802.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,560.68 / $11,566.40 / $18,435.00
| Facility | | $8,560.68 | $11,566.40 | $18,435.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $12,295.28 / $47,891.00
| Facility | | $8,787.00 | $12,295.28 | $47,891.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,810.63 / $12,221.84 / $47,891.00
| Facility | | $5,810.63 | $12,221.84 | $47,891.00 |