- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,702.60 / $11,702.60 / $13,869.90
| Facility | | $11,702.60 | $11,702.60 | $13,869.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,514.91 / $13,854.22 / $20,725.07
| Facility | | $8,514.91 | $13,854.22 | $20,725.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,571.26 / $11,846.46 / $20,155.38
| Facility | | $9,571.26 | $11,846.46 | $20,155.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,563.24 / $13,739.74 / $22,489.98
| Facility | | $8,563.24 | $13,739.74 | $22,489.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.26 / $7,905.42 / $11,476.12
| Facility | | $125.26 | $7,905.42 | $11,476.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,744.54 / $13,574.28 / $15,953.19
| Facility | | $9,744.54 | $13,574.28 | $15,953.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,794.45 / $14,478.96 / $18,251.90
| Facility | | $8,794.45 | $14,478.96 | $18,251.90 |