- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,595.01 / $13,621.20 / $22,614.40
| Facility | | $8,595.01 | $13,621.20 | $22,614.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,668.58 / $11,487.98 / $19,460.89
| Facility | | $7,668.58 | $11,487.98 | $19,460.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,611.00 / $14,528.60 / $20,890.34
| Facility | | $11,611.00 | $14,528.60 | $20,890.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,298.75 / $13,956.38 / $34,290.86
| Facility | | $7,298.75 | $13,956.38 | $34,290.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,298.75 / $13,926.02 / $19,572.33
| Facility | | $7,298.75 | $13,926.02 | $19,572.33 |