- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,414.70 / $14,573.80 / $16,492.59
| Facility | | $9,414.70 | $14,573.80 | $16,492.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,587.78 / $14,501.25 / $19,585.03
| Facility | | $9,587.78 | $14,501.25 | $19,585.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,693.79 / $13,400.00 / $18,281.80
| Facility | | $8,693.79 | $13,400.00 | $18,281.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,737.00 / $15,137.00 / $19,893.00
| Facility | | $9,737.00 | $15,137.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,843.34 / $22,417.14
| Facility | | $5,274.00 | $16,843.34 | $22,417.14 |