- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,037.90 / $11,037.90 / $13,082.10
| Facility | | $11,037.90 | $11,037.90 | $13,082.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,259.92 / $13,439.34 / $20,104.43
| Facility | | $8,259.92 | $13,439.34 | $20,104.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,027.62 / $11,173.61 / $19,010.59
| Facility | | $9,027.62 | $11,173.61 | $19,010.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,076.87 / $12,959.36 / $21,212.60
| Facility | | $8,076.87 | $12,959.36 | $21,212.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.51 / $7,668.69 / $10,956.71
| Facility | | $121.51 | $7,668.69 | $10,956.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,191.08 / $12,803.29 / $15,047.08
| Facility | | $9,191.08 | $12,803.29 | $15,047.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,294.95 / $13,656.58 / $17,215.24
| Facility | | $8,294.95 | $13,656.58 | $17,215.24 |