- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,063.50 / $11,063.50 / $13,112.40
| Facility | | $11,063.50 | $11,063.50 | $13,112.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,056.15 / $13,107.78 / $19,608.45
| Facility | | $8,056.15 | $13,107.78 | $19,608.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,048.54 / $11,199.49 / $19,054.63
| Facility | | $9,048.54 | $11,199.49 | $19,054.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,095.58 / $12,989.37 / $21,261.73
| Facility | | $8,095.58 | $12,989.37 | $21,261.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $118.51 / $7,479.50 / $10,849.37
| Facility | | $118.51 | $7,479.50 | $10,849.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,212.37 / $12,832.95 / $15,081.93
| Facility | | $9,212.37 | $12,832.95 | $15,081.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,314.16 / $13,688.21 / $17,255.11
| Facility | | $8,314.16 | $13,688.21 | $17,255.11 |