- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,938.60 / $10,938.60 / $12,964.50
| Facility | | $10,938.60 | $10,938.60 | $12,964.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,904.68 / $12,861.34 / $19,239.78
| Facility | | $7,904.68 | $12,861.34 | $19,239.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,946.45 / $11,073.14 / $18,839.66
| Facility | | $8,946.45 | $11,073.14 | $18,839.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,004.24 / $12,842.83 / $21,021.86
| Facility | | $8,004.24 | $12,842.83 | $21,021.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.28 / $7,338.87 / $10,726.97
| Facility | | $116.28 | $7,338.87 | $10,726.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,108.44 / $12,688.17 / $14,911.78
| Facility | | $9,108.44 | $12,688.17 | $14,911.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,001.40 / $13,784.96 / $18,147.18
| Facility | | $8,001.40 | $13,784.96 | $18,147.18 |