- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,591.32 / $15,494.50 / $21,440.40
| Facility | | $9,591.32 | $15,494.50 | $21,440.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,453.57 / $12,453.57 / $12,453.57
| Facility | | $12,453.57 | $12,453.57 | $12,453.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,831.08 / $14,150.55 / $21,438.39
| Facility | | $8,831.08 | $14,150.55 | $21,438.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,150.00 / $12,963.17 / $21,610.02
| Facility | | $7,150.00 | $12,963.17 | $21,610.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,150.00 / $12,963.17 / $21,001.54
| Facility | | $7,150.00 | $12,963.17 | $21,001.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,239.46 / $16,632.98 / $23,831.65
| Facility | | $7,239.46 | $16,632.98 | $23,831.65 |