- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,721.96 / $9,691.08 / $9,691.08
| Facility | | $8,721.96 | $9,691.08 | $9,691.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,133.16 / $8,133.16 / $14,913.01
| Facility | | $8,133.16 | $8,133.16 | $14,913.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,301.84 / $3,469.70 / $12,190.33
| Facility | | $2,301.84 | $3,469.70 | $12,190.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,010.85 / $11,356.30 / $17,183.18
| Facility | | $8,010.85 | $11,356.30 | $17,183.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $14,478.24 / $18,693.83
| Facility | | $6,965.00 | $14,478.24 | $18,693.83 |