- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,753.70 / $10,753.70 / $12,745.20
| Facility | | $10,753.70 | $10,753.70 | $12,745.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,378.35 / $12,004.98 / $17,958.72
| Facility | | $7,378.35 | $12,004.98 | $17,958.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,795.18 / $10,885.90 / $18,521.09
| Facility | | $8,795.18 | $10,885.90 | $18,521.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,868.90 / $12,625.66 / $20,666.39
| Facility | | $7,868.90 | $12,625.66 | $20,666.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.54 / $6,850.22 / $10,545.58
| Facility | | $108.54 | $6,850.22 | $10,545.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,954.42 / $12,473.62 / $14,659.63
| Facility | | $8,954.42 | $12,473.62 | $14,659.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,081.36 / $13,304.94 / $16,771.96
| Facility | | $8,081.36 | $13,304.94 | $16,771.96 |