- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,149.03 / $10,794.50 / $18,886.30
| Facility | | $8,149.03 | $10,794.50 | $18,886.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,648.80 / $8,355.76 / $14,815.00
| Facility | | $6,648.80 | $8,355.76 | $14,815.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,711.72 / $10,793.83 / $18,221.80
| Facility | | $5,711.72 | $10,793.83 | $18,221.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,816.55 / $11,602.54 / $17,470.00
| Facility | | $7,816.55 | $11,602.54 | $17,470.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $11,124.27 / $16,990.93
| Facility | | $3,496.00 | $11,124.27 | $16,990.93 |