- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.69 / $12,832.80 / $17,757.30
| Facility | | $7,943.69 | $12,832.80 | $17,757.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,431.41 / $11,431.41 / $17,042.41
| Facility | | $11,431.41 | $11,431.41 | $17,042.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,117.55 / $11,276.08 / $17,083.50
| Facility | | $7,117.55 | $11,276.08 | $17,083.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $10,736.31 / $17,897.77
| Facility | | $6,564.00 | $10,736.31 | $17,897.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $10,603.07 / $16,316.11
| Facility | | $6,564.00 | $10,603.07 | $16,316.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,251.20 / $13,816.26 / $19,737.77
| Facility | | $7,251.20 | $13,816.26 | $19,737.77 |