- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,782.93 / $15,143.80 / $17,137.59
| Facility | | $9,782.93 | $15,143.80 | $17,137.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,608.95 / $14,533.28 / $19,628.29
| Facility | | $9,608.95 | $14,533.28 | $19,628.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,033.82 / $13,940.15 / $18,996.82
| Facility | | $9,033.82 | $13,940.15 | $18,996.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,125.00 / $15,816.58 / $19,893.00
| Facility | | $10,125.00 | $15,816.58 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,502.09 / $23,293.89
| Facility | | $5,274.00 | $17,502.09 | $23,293.89 |