- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,245.40 / $10,245.40 / $12,142.80
| Facility | | $10,245.40 | $10,245.40 | $12,142.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,304.25 / $11,884.41 / $17,778.36
| Facility | | $7,304.25 | $11,884.41 | $17,778.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,379.46 / $10,371.36 / $17,645.66
| Facility | | $8,379.46 | $10,371.36 | $17,645.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,496.96 / $12,028.90 / $19,689.57
| Facility | | $7,496.96 | $12,028.90 | $19,689.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107.45 / $6,781.43 / $10,047.12
| Facility | | $107.45 | $6,781.43 | $10,047.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,531.18 / $11,884.04 / $13,966.72
| Facility | | $8,531.18 | $11,884.04 | $13,966.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,699.38 / $12,676.06 / $15,979.21
| Facility | | $7,699.38 | $12,676.06 | $15,979.21 |