- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,627.86 / $11,120.10 / $22,599.10
| Facility | | $8,627.86 | $11,120.10 | $22,599.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,092.35 / $8,979.76 / $12,231.72
| Facility | | $8,092.35 | $8,979.76 | $12,231.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,535.62 / $10,699.58 / $12,232.39
| Facility | | $8,535.62 | $10,699.58 | $12,232.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,886.88 / $12,190.50 / $15,854.27
| Facility | | $6,886.88 | $12,190.50 | $15,854.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,326.71 / $13,956.01 / $14,066.48
| Facility | | $10,326.71 | $13,956.01 | $14,066.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $9,776.48 / $15,056.02
| Facility | | $1,286.00 | $9,776.48 | $15,056.02 |