- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,704.57 / $11,926.50 / $13,496.80
| Facility | | $7,704.57 | $11,926.50 | $13,496.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,665.10 / $11,593.24 / $15,657.55
| Facility | | $7,665.10 | $11,593.24 | $15,657.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,114.61 / $10,978.60 / $16,338.00
| Facility | | $7,114.61 | $10,978.60 | $16,338.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,915.00 / $12,552.00 / $19,893.00
| Facility | | $7,915.00 | $12,552.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $10,699.11 / $18,301.11
| Facility | | $5,274.00 | $10,699.11 | $18,301.11 |