- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,839.44 / $13,683.30 / $15,484.80
| Facility | | $8,839.44 | $13,683.30 | $15,484.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,934.62 / $13,513.37 / $18,250.82
| Facility | | $8,934.62 | $13,513.37 | $18,250.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,162.58 / $12,595.73 / $17,164.72
| Facility | | $8,162.58 | $12,595.73 | $17,164.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,314.00 / $14,212.00 / $19,893.00
| Facility | | $9,314.00 | $14,212.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,814.17 / $21,047.38
| Facility | | $5,274.00 | $15,814.17 | $21,047.38 |