- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,078.95 / $14,054.00 / $15,904.40
| Facility | | $9,078.95 | $14,054.00 | $15,904.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,107.39 / $13,774.67 / $18,603.73
| Facility | | $9,107.39 | $13,774.67 | $18,603.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,383.75 / $12,937.02 / $17,629.81
| Facility | | $8,383.75 | $12,937.02 | $17,629.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,913.00 / $14,303.00 / $19,893.00
| Facility | | $8,913.00 | $14,303.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,242.66 / $21,617.67
| Facility | | $5,274.00 | $16,242.66 | $21,617.67 |