- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,180.67 / $8,180.67 / $9,695.70
| Facility | | $8,180.67 | $8,180.67 | $9,695.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,962.83 / $9,701.85 / $14,513.38
| Facility | | $5,962.83 | $9,701.85 | $14,513.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,690.78 / $8,281.26 / $14,089.60
| Facility | | $6,690.78 | $8,281.26 | $14,089.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,986.13 / $9,604.76 / $15,721.60
| Facility | | $5,986.13 | $9,604.76 | $15,721.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87.72 / $5,536.02 / $8,022.37
| Facility | | $87.72 | $5,536.02 | $8,022.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,811.92 / $9,489.09 / $11,152.06
| Facility | | $6,811.92 | $9,489.09 | $11,152.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,147.75 / $10,121.50 / $12,758.98
| Facility | | $6,147.75 | $10,121.50 | $12,758.98 |