- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,828.71 / $15,155.10 / $19,651.40
| Facility | | $9,828.71 | $15,155.10 | $19,651.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,684.28 / $15,074.00 / $20,418.16
| Facility | | $8,684.28 | $15,074.00 | $20,418.16 |
- 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
- $7,681.00 / $11,093.00 / $17,744.00
| Facility | | $7,681.00 | $11,093.00 | $17,744.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $17,824.00 / $19,529.00
| Facility | | $6,098.00 | $17,824.00 | $19,529.00 |