- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,960.32 / $13,870.40 / $15,696.60
| Facility | | $8,960.32 | $13,870.40 | $15,696.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,351.69 / $12,631.69 / $17,060.06
| Facility | | $8,351.69 | $12,631.69 | $17,060.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,274.20 / $12,767.97 / $17,399.43
| Facility | | $8,274.20 | $12,767.97 | $17,399.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,843.00 / $13,632.00 / $19,893.00
| Facility | | $8,843.00 | $13,632.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,958.00 / $14,051.45 / $21,283.95
| Facility | | $4,958.00 | $14,051.45 | $21,283.95 |