- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.61 / $13,482.30 / $15,257.40
| Facility | | $8,709.61 | $13,482.30 | $15,257.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.48 / $13,172.84 / $17,790.91
| Facility | | $8,709.48 | $13,172.84 | $17,790.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,042.70 / $12,410.73 / $16,912.62
| Facility | | $8,042.70 | $12,410.73 | $16,912.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,451.00 / $13,845.00 / $19,893.00
| Facility | | $8,451.00 | $13,845.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,581.90 / $20,738.25
| Facility | | $5,274.00 | $15,581.90 | $20,738.25 |