- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,038.66 / $13,991.70 / $15,833.80
| Facility | | $9,038.66 | $13,991.70 | $15,833.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,038.29 / $13,670.15 / $18,462.57
| Facility | | $9,038.29 | $13,670.15 | $18,462.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,346.54 / $12,879.60 / $17,551.57
| Facility | | $8,346.54 | $12,879.60 | $17,551.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,731.64 / $14,056.00 / $19,893.00
| Facility | | $8,731.64 | $14,056.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,170.57 / $21,521.73
| Facility | | $5,274.00 | $16,170.57 | $21,521.73 |