- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,125.38 / $16,218.10
| Facility | | $9,120.11 | $14,125.38 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,135.61 / $20,417.38
| Facility | | $10,000.00 | $15,135.61 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $13,489.63 / $17,782.79
| Facility | | $8,511.38 | $13,489.63 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,454.40 / $19,952.62
| Facility | | $9,772.37 | $14,454.40 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $13,182.57 / $21,877.62
| Facility | | $4,073.80 | $13,182.57 | $21,877.62 |