- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,784.16 / $14,190.60 / $19,636.09
| Facility | | $8,784.16 | $14,190.60 | $19,636.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,495.13 / $10,495.13 / $21,968.57
| Facility | | $10,495.13 | $10,495.13 | $21,968.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,272.46 / $13,255.46 / $20,082.31
| Facility | | $8,272.46 | $13,255.46 | $20,082.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,582.10 / $11,872.24 / $19,791.41
| Facility | | $6,582.10 | $11,872.24 | $19,791.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,582.10 / $11,872.24 / $19,234.14
| Facility | | $6,582.10 | $11,872.24 | $19,234.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,264.00 / $15,523.62 / $21,826.08
| Facility | | $7,264.00 | $15,523.62 | $21,826.08 |