- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,355.20 / $11,355.20 / $13,458.10
| Facility | | $11,355.20 | $11,355.20 | $13,458.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,180.37 / $13,309.91 / $19,910.81
| Facility | | $8,180.37 | $13,309.91 | $19,910.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,287.15 / $11,494.81 / $19,557.09
| Facility | | $9,287.15 | $11,494.81 | $19,557.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,309.04 / $13,331.89 / $21,822.39
| Facility | | $8,309.04 | $13,331.89 | $21,822.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.34 / $7,594.83 / $11,135.46
| Facility | | $120.34 | $7,594.83 | $11,135.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,455.29 / $13,171.35 / $15,479.63
| Facility | | $9,455.29 | $13,171.35 | $15,479.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,533.40 / $14,049.16 / $17,710.12
| Facility | | $8,533.40 | $14,049.16 | $17,710.12 |