- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,144.70 / $13,144.70 / $15,579.10
| Facility | | $13,144.70 | $13,144.70 | $15,579.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,394.29 / $15,285.03 / $22,865.47
| Facility | | $9,394.29 | $15,285.03 | $22,865.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,750.76 / $13,306.34 / $22,639.19
| Facility | | $10,750.76 | $13,306.34 | $22,639.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,618.52 / $15,432.93 / $25,261.49
| Facility | | $9,618.52 | $15,432.93 | $25,261.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.19 / $8,721.87 / $12,890.35
| Facility | | $138.19 | $8,721.87 | $12,890.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,945.40 / $15,247.08 / $17,919.15
| Facility | | $10,945.40 | $15,247.08 | $17,919.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,878.21 / $16,263.24 / $20,501.14
| Facility | | $9,878.21 | $16,263.24 | $20,501.14 |