- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,550.95 / $11,270.80 / $29,945.50
| Facility | | $8,550.95 | $11,270.80 | $29,945.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,008.96 / $9,294.50 / $16,818.75
| Facility | | $7,008.96 | $9,294.50 | $16,818.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,719.92 / $10,066.83 / $17,053.43
| Facility | | $6,719.92 | $10,066.83 | $17,053.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,705.12 / $12,009.30 / $17,267.90
| Facility | | $9,705.12 | $12,009.30 | $17,267.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,033.13 / $12,105.83 / $21,993.00
| Facility | | $6,033.13 | $12,105.83 | $21,993.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,033.13 / $11,511.20 / $16,178.43
| Facility | | $6,033.13 | $11,511.20 | $16,178.43 |