- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,767.30 / $12,767.30 / $15,131.70
| Facility | | $12,767.30 | $12,767.30 | $15,131.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,384.49 / $15,269.07 / $22,841.60
| Facility | | $9,384.49 | $15,269.07 | $22,841.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,442.04 / $12,924.24 / $21,989.10
| Facility | | $10,442.04 | $12,924.24 | $21,989.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,342.32 / $14,989.77 / $24,536.10
| Facility | | $9,342.32 | $14,989.77 | $24,536.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.05 / $8,712.76 / $12,520.20
| Facility | | $138.05 | $8,712.76 | $12,520.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,631.10 / $14,809.26 / $17,404.59
| Facility | | $10,631.10 | $14,809.26 | $17,404.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,594.57 / $15,796.24 / $19,912.45
| Facility | | $9,594.57 | $15,796.24 | $19,912.45 |