- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $10,964.78 / $11,481.54
| Facility | | $9,332.54 | $10,964.78 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $12,022.64 / $16,982.44
| Facility | | $6,760.83 | $12,022.64 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $9,772.37 / $17,378.01
| Facility | | $7,244.36 | $9,772.37 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $9,332.54 / $11,748.98
| Facility | | $8,128.31 | $9,332.54 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $10,964.78 / $17,782.79
| Facility | | $6,760.83 | $10,964.78 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77.62 / $7,079.46 / $9,332.54
| Facility | | $77.62 | $7,079.46 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $12,882.50 / $13,182.57
| Facility | | $10,232.93 | $12,882.50 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $11,748.98 / $15,848.93
| Facility | | $6,760.83 | $11,748.98 | $15,848.93 |