- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,392.79 / $10,392.79 / $12,317.50
| Facility | | $10,392.79 | $10,392.79 | $12,317.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,327.14 / $11,921.65 / $17,834.06
| Facility | | $7,327.14 | $11,921.65 | $17,834.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,500.00 / $10,520.55 / $17,899.49
| Facility | | $8,500.00 | $10,520.55 | $17,899.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,604.80 / $12,201.92 / $19,972.79
| Facility | | $7,604.80 | $12,201.92 | $19,972.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.79 / $6,802.67 / $10,191.65
| Facility | | $107.79 | $6,802.67 | $10,191.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,653.89 / $12,054.98 / $14,167.63
| Facility | | $8,653.89 | $12,054.98 | $14,167.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,810.13 / $12,858.40 / $16,209.06
| Facility | | $7,810.13 | $12,858.40 | $16,209.06 |