- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,553.70 / $11,553.70 / $13,693.40
| Facility | | $11,553.70 | $11,553.70 | $13,693.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,485.49 / $13,806.35 / $20,653.46
| Facility | | $8,485.49 | $13,806.35 | $20,653.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,449.50 / $11,695.75 / $19,898.97
| Facility | | $9,449.50 | $11,695.75 | $19,898.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,454.29 / $13,564.95 / $22,203.87
| Facility | | $8,454.29 | $13,564.95 | $22,203.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $124.83 / $7,878.11 / $11,330.12
| Facility | | $124.83 | $7,878.11 | $11,330.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,620.58 / $13,401.60 / $15,750.23
| Facility | | $9,620.58 | $13,401.60 | $15,750.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,682.57 / $14,294.76 / $18,019.71
| Facility | | $8,682.57 | $14,294.76 | $18,019.71 |