- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,173.30 / $12,173.30 / $14,427.70
| Facility | | $12,173.30 | $12,173.30 | $14,427.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,745.93 / $14,230.09 / $21,287.35
| Facility | | $8,745.93 | $14,230.09 | $21,287.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,956.23 / $12,322.94 / $20,966.05
| Facility | | $9,956.23 | $12,322.94 | $20,966.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,907.67 / $14,292.37 / $23,394.55
| Facility | | $8,907.67 | $14,292.37 | $23,394.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.66 / $8,119.90 / $11,937.70
| Facility | | $128.66 | $8,119.90 | $11,937.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,136.49 / $14,120.25 / $16,594.84
| Facility | | $10,136.49 | $14,120.25 | $16,594.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,148.18 / $15,061.31 / $18,986.00
| Facility | | $9,148.18 | $15,061.31 | $18,986.00 |