- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,292.00 / $10,292.00 / $12,198.10
| Facility | | $10,292.00 | $10,292.00 | $12,198.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.40 / $12,203.55 / $18,255.78
| Facility | | $7,500.40 | $12,203.55 | $18,255.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,417.59 / $10,418.54 / $17,725.96
| Facility | | $8,417.59 | $10,418.54 | $17,725.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,531.08 / $12,083.63 / $19,779.16
| Facility | | $7,531.08 | $12,083.63 | $19,779.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.33 / $6,963.53 / $10,092.85
| Facility | | $110.33 | $6,963.53 | $10,092.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,570.00 / $11,938.11 / $14,030.28
| Facility | | $8,570.00 | $11,938.11 | $14,030.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,734.42 / $12,733.74 / $16,051.92
| Facility | | $7,734.42 | $12,733.74 | $16,051.92 |