- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,827.40 / $11,827.40 / $14,017.80
| Facility | | $11,827.40 | $11,827.40 | $14,017.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,474.59 / $13,788.62 / $20,626.93
| Facility | | $8,474.59 | $13,788.62 | $20,626.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,673.34 / $11,972.81 / $20,370.34
| Facility | | $9,673.34 | $11,972.81 | $20,370.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,654.58 / $13,886.29 / $22,729.85
| Facility | | $8,654.58 | $13,886.29 | $22,729.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.67 / $7,867.99 / $11,598.52
| Facility | | $124.67 | $7,867.99 | $11,598.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,848.48 / $13,719.06 / $16,123.34
| Facility | | $9,848.48 | $13,719.06 | $16,123.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,888.25 / $14,633.38 / $18,446.57
| Facility | | $8,888.25 | $14,633.38 | $18,446.57 |