- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,566.92 / $14,809.40 / $16,759.20
| Facility | | $9,566.92 | $14,809.40 | $16,759.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,692.56 / $14,659.71 / $19,799.05
| Facility | | $9,692.56 | $14,659.71 | $19,799.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,834.36 / $13,400.00 / $18,577.37
| Facility | | $8,834.36 | $13,400.00 | $18,577.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,750.79 / $15,381.00 / $19,893.00
| Facility | | $9,750.79 | $15,381.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,958.00 / $13,817.84 / $22,724.86
| Facility | | $4,958.00 | $13,817.84 | $22,724.86 |