- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,347.70 / $11,347.70 / $13,449.20
| Facility | | $11,347.70 | $11,347.70 | $13,449.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,234.86 / $13,398.56 / $20,043.43
| Facility | | $8,234.86 | $13,398.56 | $20,043.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,281.00 / $11,487.20 / $19,544.14
| Facility | | $9,281.00 | $11,487.20 | $19,544.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,303.54 / $13,323.07 / $21,807.94
| Facility | | $8,303.54 | $13,323.07 | $21,807.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $121.14 / $7,645.42 / $11,128.09
| Facility | | $121.14 | $7,645.42 | $11,128.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,449.03 / $13,162.62 / $15,469.38
| Facility | | $9,449.03 | $13,162.62 | $15,469.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,527.75 / $14,039.86 / $17,698.39
| Facility | | $8,527.75 | $14,039.86 | $17,698.39 |