- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,402.70 / $14,093.60 / $23,398.70
| Facility | | $9,402.70 | $14,093.60 | $23,398.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,337.78 / $14,294.66 / $24,788.42
| Facility | | $9,337.78 | $14,294.66 | $24,788.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,148.25 / $14,392.06 / $27,612.00
| Facility | | $12,148.25 | $14,392.06 | $27,612.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $15,091.67 / $24,192.58
| Facility | | $8,787.00 | $15,091.67 | $24,192.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,226.00 / $13,958.28 / $19,597.41
| Facility | | $9,226.00 | $13,958.28 | $19,597.41 |