- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,869.14 / $15,943.30 / $22,061.40
| Facility | | $9,869.14 | $15,943.30 | $22,061.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,466.15 / $7,466.15 / $7,466.15
| Facility | | $7,466.15 | $7,466.15 | $7,466.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,272.43 / $14,857.75 / $22,509.82
| Facility | | $9,272.43 | $14,857.75 | $22,509.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,150.00 / $13,338.65 / $22,835.06
| Facility | | $7,150.00 | $13,338.65 | $22,835.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,883.85 / $12,983.93 / $20,270.93
| Facility | | $6,883.85 | $12,983.93 | $20,270.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,449.15 / $17,464.24 / $25,053.47
| Facility | | $7,449.15 | $17,464.24 | $25,053.47 |