- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,144.70 / $12,144.70 / $14,393.90
| Facility | | $12,144.70 | $12,144.70 | $14,393.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,836.37 / $14,377.25 / $21,507.50
| Facility | | $8,836.37 | $14,377.25 | $21,507.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,932.86 / $12,294.01 / $20,916.84
| Facility | | $9,932.86 | $12,294.01 | $20,916.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,886.76 / $14,258.82 / $23,339.64
| Facility | | $8,886.76 | $14,258.82 | $23,339.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $129.99 / $8,203.87 / $11,909.68
| Facility | | $129.99 | $8,203.87 | $11,909.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,112.69 / $14,087.11 / $16,555.89
| Facility | | $10,112.69 | $14,087.11 | $16,555.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,126.70 / $15,025.96 / $18,941.45
| Facility | | $9,126.70 | $15,025.96 | $18,941.45 |