- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,247.00 / $13,341.30 / $22,149.70
| Facility | | $9,247.00 | $13,341.30 | $22,149.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,999.12 / $12,007.68 / $20,294.75
| Facility | | $7,999.12 | $12,007.68 | $20,294.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,499.77 / $14,230.02 / $20,461.03
| Facility | | $11,499.77 | $14,230.02 | $20,461.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,148.75 / $14,286.06 / $35,074.58
| Facility | | $7,148.75 | $14,286.06 | $35,074.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,148.75 / $13,639.82 / $19,170.09
| Facility | | $7,148.75 | $13,639.82 | $19,170.09 |