- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,886.70 / $14,356.20 / $19,865.30
| Facility | | $8,886.70 | $14,356.20 | $19,865.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,294.29 / $13,294.29 / $13,294.29
| Facility | | $13,294.29 | $13,294.29 | $13,294.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,274.10 / $13,258.07 / $20,086.25
| Facility | | $8,274.10 | $13,258.07 | $20,086.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,658.94 / $12,010.83 / $20,022.43
| Facility | | $6,658.94 | $12,010.83 | $20,022.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,658.94 / $11,861.77 / $18,253.00
| Facility | | $6,658.94 | $11,861.77 | $18,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,264.00 / $15,583.93 / $22,080.86
| Facility | | $7,264.00 | $15,583.93 | $22,080.86 |