- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,654.06 / $9,181.54 / $15,366.70
| Facility | | $6,654.06 | $9,181.54 | $15,366.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,007.11 / $10,007.11 / $14,469.22
| Facility | | $10,007.11 | $10,007.11 | $14,469.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $10,349.35 / $16,244.46
| Facility | | $2,423.00 | $10,349.35 | $16,244.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,810.38 / $10,329.64 / $17,322.74
| Facility | | $6,810.38 | $10,329.64 | $17,322.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $8,336.59 / $18,537.37
| Facility | | $2,600.00 | $8,336.59 | $18,537.37 |