- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,947.00 / $14,132.70 / $22,824.20
| Facility | | $1,947.00 | $14,132.70 | $22,824.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,718.00 / $15,198.96 / $19,699.03
| Facility | | $9,718.00 | $15,198.96 | $19,699.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,799.62 / $15,628.44 / $25,048.65
| Facility | | $9,799.62 | $15,628.44 | $25,048.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,045.29 / $14,415.56 / $26,529.04
| Facility | | $8,045.29 | $14,415.56 | $26,529.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,302.25 / $15,244.92 / $24,151.00
| Facility | | $8,302.25 | $15,244.92 | $24,151.00 |