- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,827.40 / $10,827.40 / $12,832.60
| Facility | | $10,827.40 | $10,827.40 | $12,832.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,773.91 / $12,648.58 / $18,921.50
| Facility | | $7,773.91 | $12,648.58 | $18,921.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,855.45 / $10,960.49 / $18,648.00
| Facility | | $8,855.45 | $10,960.49 | $18,648.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,922.82 / $12,712.18 / $20,808.00
| Facility | | $7,922.82 | $12,712.18 | $20,808.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.36 / $7,217.47 / $10,617.84
| Facility | | $114.36 | $7,217.47 | $10,617.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,015.78 / $12,559.09 / $14,760.08
| Facility | | $9,015.78 | $12,559.09 | $14,760.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,136.73 / $13,396.10 / $16,886.88
| Facility | | $8,136.73 | $13,396.10 | $16,886.88 |