- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,440.87 / $12,765.10 / $21,193.10
| Facility | | $9,440.87 | $12,765.10 | $21,193.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,212.00 / $10,432.46 / $23,396.16
| Facility | | $7,212.00 | $10,432.46 | $23,396.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,542.69 / $11,299.40 / $19,141.41
| Facility | | $7,542.69 | $11,299.40 | $19,141.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,003.10 / $13,615.43 / $19,577.33
| Facility | | $11,003.10 | $13,615.43 | $19,577.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,840.00 / $13,669.06 / $33,727.94
| Facility | | $6,840.00 | $13,669.06 | $33,727.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,840.00 / $13,050.72 / $18,342.14
| Facility | | $6,840.00 | $13,050.72 | $18,342.14 |