- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,522.10 / $10,522.10 / $12,470.80
| Facility | | $10,522.10 | $10,522.10 | $12,470.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,657.32 / $12,458.87 / $18,637.71
| Facility | | $7,657.32 | $12,458.87 | $18,637.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,605.77 / $10,651.46 / $18,122.23
| Facility | | $8,605.77 | $10,651.46 | $18,122.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,699.44 / $12,353.76 / $20,221.33
| Facility | | $7,699.44 | $12,353.76 | $20,221.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $112.64 / $7,109.22 / $10,318.48
| Facility | | $112.64 | $7,109.22 | $10,318.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,761.58 / $12,204.99 / $14,343.93
| Facility | | $8,761.58 | $12,204.99 | $14,343.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,907.32 / $13,018.41 / $16,410.75
| Facility | | $7,907.32 | $13,018.41 | $16,410.75 |