- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,176.83 / $12,467.50 / $18,570.00
| Facility | | $9,176.83 | $12,467.50 | $18,570.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,468.00 / $11,593.05 / $17,316.00
| Facility | | $7,468.00 | $11,593.05 | $17,316.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,005.60 / $11,229.25 / $20,004.00
| Facility | | $8,005.60 | $11,229.25 | $20,004.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $85.10 / $117.76 / $186.81
| Facility | | $85.10 | $117.76 | $186.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,817.76 / $12,203.44 / $20,084.02
| Facility | | $8,817.76 | $12,203.44 | $20,084.02 |