- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,257.40 / $10,257.40 / $12,157.10
| Facility | | $10,257.40 | $10,257.40 | $12,157.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,439.38 / $12,104.27 / $18,107.25
| Facility | | $7,439.38 | $12,104.27 | $18,107.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,389.29 / $10,383.54 / $17,666.39
| Facility | | $8,389.29 | $10,383.54 | $17,666.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,505.77 / $12,043.02 / $19,712.68
| Facility | | $7,505.77 | $12,043.02 | $19,712.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109.44 / $6,906.88 / $10,058.93
| Facility | | $109.44 | $6,906.88 | $10,058.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,541.19 / $11,897.99 / $13,983.13
| Facility | | $8,541.19 | $11,897.99 | $13,983.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,708.43 / $12,690.95 / $15,997.97
| Facility | | $7,708.43 | $12,690.95 | $15,997.97 |