- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,371.70 / $11,371.70 / $13,477.80
| Facility | | $11,371.70 | $11,371.70 | $13,477.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,174.92 / $13,301.04 / $19,897.55
| Facility | | $8,174.92 | $13,301.04 | $19,897.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,300.68 / $11,511.56 / $19,585.58
| Facility | | $9,300.68 | $11,511.56 | $19,585.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,321.16 / $13,351.32 / $21,854.18
| Facility | | $8,321.16 | $13,351.32 | $21,854.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.26 / $7,589.77 / $11,151.68
| Facility | | $120.26 | $7,589.77 | $11,151.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,469.07 / $13,190.53 / $15,502.18
| Facility | | $9,469.07 | $13,190.53 | $15,502.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,545.83 / $14,069.63 / $17,735.91
| Facility | | $8,545.83 | $14,069.63 | $17,735.91 |