- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,353.70 / $11,353.70 / $13,456.40
| Facility | | $11,353.70 | $11,353.70 | $13,456.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,387.42 / $13,646.78 / $20,414.75
| Facility | | $8,387.42 | $13,646.78 | $20,414.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,285.92 / $11,493.29 / $19,554.50
| Facility | | $9,285.92 | $11,493.29 | $19,554.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,307.95 / $13,330.13 / $21,819.50
| Facility | | $8,307.95 | $13,330.13 | $21,819.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $123.38 / $7,787.05 / $11,133.99
| Facility | | $123.38 | $7,787.05 | $11,133.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,454.04 / $13,169.60 / $15,477.58
| Facility | | $9,454.04 | $13,169.60 | $15,477.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,305.00 / $14,308.01 / $18,835.74
| Facility | | $8,305.00 | $14,308.01 | $18,835.74 |