- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,141.70 / $12,141.70 / $14,390.30
| Facility | | $12,141.70 | $12,141.70 | $14,390.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,837.45 / $14,379.03 / $21,510.15
| Facility | | $8,837.45 | $14,379.03 | $21,510.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,930.40 / $12,290.97 / $20,911.66
| Facility | | $9,930.40 | $12,290.97 | $20,911.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,884.56 / $14,255.29 / $23,333.86
| Facility | | $8,884.56 | $14,255.29 | $23,333.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.00 / $8,204.89 / $11,906.73
| Facility | | $130.00 | $8,204.89 | $11,906.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,110.19 / $14,083.62 / $16,551.79
| Facility | | $10,110.19 | $14,083.62 | $16,551.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,124.44 / $15,022.24 / $18,936.75
| Facility | | $9,124.44 | $15,022.24 | $18,936.75 |