- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,997.25 / $13,927.60 / $15,761.30
| Facility | | $8,997.25 | $13,927.60 | $15,761.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,112.95 / $13,783.10 / $18,615.11
| Facility | | $9,112.95 | $13,783.10 | $18,615.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,302.68 / $12,820.60 / $17,471.16
| Facility | | $8,302.68 | $12,820.60 | $17,471.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,517.00 / $14,039.00 / $19,893.00
| Facility | | $8,517.00 | $14,039.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $11,909.16 / $21,371.68
| Facility | | $4,008.00 | $11,909.16 | $21,371.68 |