- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,845.04 / $13,691.90 / $15,494.60
| Facility | | $8,845.04 | $13,691.90 | $15,494.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,071.93 / $12,208.56 / $16,488.58
| Facility | | $8,071.93 | $12,208.56 | $16,488.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,167.75 / $12,603.70 / $17,175.59
| Facility | | $8,167.75 | $12,603.70 | $17,175.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,452.00 / $14,047.00 / $19,893.00
| Facility | | $8,452.00 | $14,047.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,824.18 / $21,060.70
| Facility | | $5,274.00 | $15,824.18 | $21,060.70 |