- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,767.50 / $14,795.50 / $17,865.30
| Facility | | $7,767.50 | $14,795.50 | $17,865.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $13,360.10 / $22,586.47
| Facility | | $6,916.00 | $13,360.10 | $22,586.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,478.44 / $12,976.28 / $16,900.41
| Facility | | $11,478.44 | $12,976.28 | $16,900.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,310.81 / $10,307.10 / $13,578.33
| Facility | | $7,310.81 | $10,307.10 | $13,578.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,988.00 / $13,266.10 / $20,036.88
| Facility | | $7,988.00 | $13,266.10 | $20,036.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,565.27 / $11,871.43 / $15,018.71
| Facility | | $8,565.27 | $11,871.43 | $15,018.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,181.93 / $17,548.34
| Facility | | $3,775.00 | $12,181.93 | $17,548.34 |