- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,358.75 / $14,487.20 / $16,394.50
| Facility | | $9,358.75 | $14,487.20 | $16,394.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.14 / $12,579.43 / $16,989.48
| Facility | | $8,317.14 | $12,579.43 | $16,989.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,642.12 / $13,335.72 / $17,728.00
| Facility | | $8,642.12 | $13,335.72 | $17,728.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,528.00 / $14,636.00 / $19,893.00
| Facility | | $9,528.00 | $14,636.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,743.23 / $22,283.89
| Facility | | $5,274.00 | $16,743.23 | $22,283.89 |