- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,061.60 / $12,479.20 / $14,122.20
| Facility | | $8,061.60 | $12,479.20 | $14,122.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,484.53 / $11,320.14 / $15,288.71
| Facility | | $7,484.53 | $11,320.14 | $15,288.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,444.30 / $11,487.34 / $16,070.61
| Facility | | $7,444.30 | $11,487.34 | $16,070.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,815.00 / $12,557.00 / $19,893.00
| Facility | | $7,815.00 | $12,557.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $12,782.90 / $19,149.18
| Facility | | $5,274.00 | $12,782.90 | $19,149.18 |