- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,092.10 / $13,092.10 / $15,516.70
| Facility | | $13,092.10 | $13,092.10 | $15,516.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,599.16 / $15,618.35 / $23,364.11
| Facility | | $9,599.16 | $15,618.35 | $23,364.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,707.71 / $13,253.06 / $22,548.54
| Facility | | $10,707.71 | $13,253.06 | $22,548.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,580.00 / $15,371.14 / $25,160.34
| Facility | | $9,580.00 | $15,371.14 | $25,160.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141.21 / $8,912.07 / $12,838.74
| Facility | | $141.21 | $8,912.07 | $12,838.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,901.57 / $15,186.03 / $17,847.40
| Facility | | $10,901.57 | $15,186.03 | $17,847.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,838.67 / $16,198.12 / $20,419.05
| Facility | | $9,838.67 | $16,198.12 | $20,419.05 |