- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,295.00 / $15,800.30 / $19,078.50
| Facility | | $8,295.00 | $15,800.30 | $19,078.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $14,267.40 / $23,500.80
| Facility | | $6,916.00 | $14,267.40 | $23,500.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,130.60 / $13,671.00 / $17,524.93
| Facility | | $12,130.60 | $13,671.00 | $17,524.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,057.47 / $11,328.00 / $15,034.80
| Facility | | $8,057.47 | $11,328.00 | $15,034.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,147.46 / $14,036.47 / $20,848.00
| Facility | | $8,147.46 | $14,036.47 | $20,848.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.00 / $12,374.73 / $15,365.45
| Facility | | $8,912.00 | $12,374.73 | $15,365.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $13,009.21 / $18,740.06
| Facility | | $3,775.00 | $13,009.21 | $18,740.06 |