- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,959.20 / $13,868.70 / $15,694.60
| Facility | | $8,959.20 | $13,868.70 | $15,694.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,855.49 / $13,393.68 / $18,089.16
| Facility | | $8,855.49 | $13,393.68 | $18,089.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,273.17 / $12,766.37 / $17,397.27
| Facility | | $8,273.17 | $12,766.37 | $17,397.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,663.00 / $14,056.00 / $19,893.00
| Facility | | $8,663.00 | $14,056.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,028.41 / $21,332.52
| Facility | | $5,274.00 | $16,028.41 | $21,332.52 |