- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,846.25 / $14,945.50 / $18,046.40
| Facility | | $7,846.25 | $14,945.50 | $18,046.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $13,495.55 / $21,521.59
| Facility | | $6,916.00 | $13,495.55 | $21,521.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,436.40 / $13,081.40 / $16,976.02
| Facility | | $10,436.40 | $13,081.40 | $16,976.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,962.70 / $12,224.85 / $16,535.68
| Facility | | $7,962.70 | $12,224.85 | $16,535.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,988.00 / $13,538.32 / $20,759.97
| Facility | | $7,988.00 | $13,538.32 | $20,759.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,885.17 / $12,229.19 / $17,572.18
| Facility | | $8,885.17 | $12,229.19 | $17,572.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,305.43 / $17,726.25
| Facility | | $3,775.00 | $12,305.43 | $17,726.25 |