- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $13,489.63 / $14,125.38
| Facility | | $11,481.54 | $13,489.63 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $14,454.40 / $20,892.96
| Facility | | $8,317.64 | $14,454.40 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $12,022.64 / $21,379.62
| Facility | | $8,709.64 | $12,022.64 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $11,220.18 / $14,454.40
| Facility | | $10,000.00 | $11,220.18 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $13,489.63 / $21,877.62
| Facility | | $8,317.64 | $13,489.63 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $95.50 / $8,511.38 / $11,220.18
| Facility | | $95.50 | $8,511.38 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $15,488.17 / $16,218.10
| Facility | | $12,589.25 | $15,488.17 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $14,454.40 / $19,498.45
| Facility | | $8,317.64 | $14,454.40 | $19,498.45 |