- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,105.46 / $10,446.79 / $21,230.70
| Facility | | $8,105.46 | $10,446.79 | $21,230.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,585.45 / $8,585.45 / $11,468.50
| Facility | | $8,585.45 | $8,585.45 | $11,468.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,814.97 / $9,796.23 / $11,199.62
| Facility | | $7,814.97 | $9,796.23 | $11,199.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,469.89 / $11,452.39 / $14,894.32
| Facility | | $6,469.89 | $11,452.39 | $14,894.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,411.05 / $13,411.05 / $13,411.05
| Facility | | $13,411.05 | $13,411.05 | $13,411.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $9,184.53 / $14,144.41
| Facility | | $1,286.00 | $9,184.53 | $14,144.41 |