- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,748.94 / $14,769.70 / $25,990.30
| Facility | | $8,748.94 | $14,769.70 | $25,990.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,531.98 / $13,542.02 / $22,390.97
| Facility | | $9,531.98 | $13,542.02 | $22,390.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,958.53 / $13,614.02 / $18,943.66
| Facility | | $7,958.53 | $13,614.02 | $18,943.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,614.70 / $28,614.70 / $33,581.78
| Facility | | $28,614.70 | $28,614.70 | $33,581.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,871.64 / $18,385.66
| Facility | | $1,787.00 | $12,871.64 | $18,385.66 |