- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,107.10 / $13,107.10 / $15,534.50
| Facility | | $13,107.10 | $13,107.10 | $15,534.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,494.54 / $15,448.14 / $23,109.48
| Facility | | $9,494.54 | $15,448.14 | $23,109.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,720.01 / $13,268.28 / $22,574.44
| Facility | | $10,720.01 | $13,268.28 | $22,574.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,591.01 / $15,388.80 / $25,189.24
| Facility | | $9,591.01 | $15,388.80 | $25,189.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $139.66 / $8,814.94 / $12,853.49
| Facility | | $139.66 | $8,814.94 | $12,853.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,914.10 / $15,203.48 / $17,867.90
| Facility | | $10,914.10 | $15,203.48 | $17,867.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,849.96 / $16,216.73 / $20,442.50
| Facility | | $9,849.96 | $16,216.73 | $20,442.50 |