- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,039.40 / $12,039.40 / $14,269.10
| Facility | | $12,039.40 | $12,039.40 | $14,269.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,165.12 / $13,285.08 / $19,873.68
| Facility | | $8,165.12 | $13,285.08 | $19,873.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,846.76 / $12,187.45 / $20,735.54
| Facility | | $9,846.76 | $12,187.45 | $20,735.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,809.73 / $14,135.23 / $23,137.34
| Facility | | $8,809.73 | $14,135.23 | $23,137.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.11 / $7,580.67 / $11,806.45
| Facility | | $120.11 | $7,580.67 | $11,806.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,025.04 / $13,965.01 / $16,412.39
| Facility | | $10,025.04 | $13,965.01 | $16,412.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,047.60 / $14,895.72 / $18,777.27
| Facility | | $9,047.60 | $14,895.72 | $18,777.27 |