- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,780.90 / $16,224.90 / $21,772.50
| Facility | | $9,780.90 | $16,224.90 | $21,772.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,972.96 / $11,974.95 / $14,544.46
| Facility | | $7,972.96 | $11,974.95 | $14,544.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,852.33 / $13,752.81 / $22,005.02
| Facility | | $7,852.33 | $13,752.81 | $22,005.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,031.44 / $13,063.50 / $29,959.83
| Facility | | $8,031.44 | $13,063.50 | $29,959.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,535.48 / $12,868.42 / $18,229.68
| Facility | | $9,535.48 | $12,868.42 | $18,229.68 |