- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,621.76 / $14,901.20 / $16,855.30
| Facility | | $9,621.76 | $14,901.20 | $16,855.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,646.65 / $16,102.76 / $22,147.26
| Facility | | $10,646.65 | $16,102.76 | $22,147.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,885.00 / $13,710.50 / $22,693.00
| Facility | | $8,885.00 | $13,710.50 | $22,693.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,362.00 / $16,257.00 / $25,651.00
| Facility | | $10,362.00 | $16,257.00 | $25,651.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,213.77 / $22,910.15
| Facility | | $5,274.00 | $17,213.77 | $22,910.15 |