- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,769.00 / $14,760.70 / $20,284.50
| Facility | | $10,769.00 | $14,760.70 | $20,284.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,732.59 / $11,893.84 / $12,480.00
| Facility | | $11,732.59 | $11,893.84 | $12,480.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,359.60 / $13,395.07 / $20,293.82
| Facility | | $8,359.60 | $13,395.07 | $20,293.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,755.87 / $13,554.42 / $20,995.84
| Facility | | $8,755.87 | $13,554.42 | $20,995.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,968.96 / $13,554.42 / $19,869.33
| Facility | | $7,968.96 | $13,554.42 | $19,869.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,428.94 / $14,832.11 / $22,043.67
| Facility | | $7,428.94 | $14,832.11 | $22,043.67 |