- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,158.60 / $10,807.20 / $18,908.50
| Facility | | $8,158.60 | $10,807.20 | $18,908.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,221.67 / $8,717.45 / $14,815.00
| Facility | | $8,221.67 | $8,717.45 | $14,815.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,817.38 / $10,144.77 / $18,558.89
| Facility | | $5,817.38 | $10,144.77 | $18,558.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,825.73 / $11,616.16 / $17,470.00
| Facility | | $7,825.73 | $11,616.16 | $17,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $11,137.33 / $17,010.89
| Facility | | $3,496.00 | $11,137.33 | $17,010.89 |