- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $10,232.93 / $11,748.98
| Facility | | $7,943.28 | $10,232.93 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $10,715.19 / $10,715.19
| Facility | | $8,317.64 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $9,120.11 / $10,964.78
| Facility | | $7,762.47 | $9,120.11 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,748.98 / $14,454.40
| Facility | | $7,244.36 | $11,748.98 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $9,549.93 / $12,302.69
| Facility | | $9,549.93 | $9,549.93 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $10,715.19 / $13,803.84
| Facility | | $1,513.56 | $10,715.19 | $13,803.84 |