- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,944.40 / $14,057.90 / $23,315.50
| Facility | | $10,944.40 | $14,057.90 | $23,315.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,108.50 / $7,437.96 / $11,921.00
| Facility | | $7,108.50 | $7,437.96 | $11,921.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,387.03 / $12,839.21 / $22,334.99
| Facility | | $8,387.03 | $12,839.21 | $22,334.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,086.43 / $14,978.96 / $21,559.00
| Facility | | $11,086.43 | $14,978.96 | $21,559.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $15,037.96 / $24,106.49
| Facility | | $8,787.00 | $15,037.96 | $24,106.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,525.00 / $14,357.70 / $20,179.04
| Facility | | $7,525.00 | $14,357.70 | $20,179.04 |