- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,538.60 / $10,538.60 / $12,490.40
| Facility | | $10,538.60 | $10,538.60 | $12,490.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,606.10 / $12,375.54 / $18,513.05
| Facility | | $7,606.10 | $12,375.54 | $18,513.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,619.29 / $10,668.21 / $18,150.72
| Facility | | $8,619.29 | $10,668.21 | $18,150.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,711.54 / $12,373.18 / $20,253.12
| Facility | | $7,711.54 | $12,373.18 | $20,253.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $111.89 / $7,061.67 / $10,334.70
| Facility | | $111.89 | $7,061.67 | $10,334.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,775.35 / $12,224.18 / $14,366.48
| Facility | | $8,775.35 | $12,224.18 | $14,366.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,919.75 / $13,038.87 / $16,436.56
| Facility | | $7,919.75 | $13,038.87 | $16,436.56 |