- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,335.60 / $11,335.60 / $13,435.00
| Facility | | $11,335.60 | $11,335.60 | $13,435.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,126.23 / $14,848.87 / $22,213.01
| Facility | | $9,126.23 | $14,848.87 | $22,213.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,271.16 / $11,475.02 / $19,523.41
| Facility | | $9,271.16 | $11,475.02 | $19,523.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,294.75 / $13,308.94 / $21,784.82
| Facility | | $8,294.75 | $13,308.94 | $21,784.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.25 / $8,472.99 / $12,105.86
| Facility | | $134.25 | $8,472.99 | $12,105.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,439.02 / $13,148.67 / $15,452.98
| Facility | | $9,439.02 | $13,148.67 | $15,452.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,518.70 / $14,024.98 / $17,679.63
| Facility | | $8,518.70 | $14,024.98 | $17,679.63 |