- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,309.98 / $13,880.20 / $23,044.40
| Facility | | $9,309.98 | $13,880.20 | $23,044.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,522.16 / $12,734.83 / $25,807.80
| Facility | | $8,522.16 | $12,734.83 | $25,807.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,435.28 / $12,508.09 / $20,735.22
| Facility | | $6,435.28 | $12,508.09 | $20,735.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,957.52 / $14,804.79 / $19,693.00
| Facility | | $10,957.52 | $14,804.79 | $19,693.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,437.50 / $14,863.10 / $36,536.28
| Facility | | $7,437.50 | $14,863.10 | $36,536.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,960.99 / $13,418.44 / $19,689.74
| Facility | | $8,960.99 | $13,418.44 | $19,689.74 |