- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,409.40 / $12,409.40 / $14,707.50
| Facility | | $12,409.40 | $12,409.40 | $14,707.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,991.45 / $16,256.63 / $24,318.93
| Facility | | $9,991.45 | $16,256.63 | $24,318.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,149.32 / $12,561.94 / $21,372.68
| Facility | | $10,149.32 | $12,561.94 | $21,372.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,080.43 / $14,569.57 / $23,848.28
| Facility | | $9,080.43 | $14,569.57 | $23,848.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $146.97 / $9,276.28 / $13,253.57
| Facility | | $146.97 | $9,276.28 | $13,253.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,333.08 / $14,394.11 / $16,916.68
| Facility | | $10,333.08 | $14,394.11 | $16,916.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,077.20 / $15,638.37 / $20,587.09
| Facility | | $9,077.20 | $15,638.37 | $20,587.09 |