- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,573.21 / $14,761.10 / $19,140.50
| Facility | | $9,573.21 | $14,761.10 | $19,140.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,458.53 / $14,651.00 / $19,887.38
| Facility | | $8,458.53 | $14,651.00 | $19,887.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,494.00 / $11,477.00 / $18,553.00
| Facility | | $7,494.00 | $11,477.00 | $18,553.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $17,640.95 / $19,529.00
| Facility | | $6,098.00 | $17,640.95 | $19,529.00 |