- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,979.21 / $9,979.21 / $11,827.30
| Facility | | $9,979.21 | $9,979.21 | $11,827.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,974.08 / $11,347.20 / $16,974.72
| Facility | | $6,974.08 | $11,347.20 | $16,974.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,161.77 / $10,101.92 / $17,187.24
| Facility | | $8,161.77 | $10,101.92 | $17,187.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,302.19 / $11,716.39 / $19,178.04
| Facility | | $7,302.19 | $11,716.39 | $19,178.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.59 / $6,474.88 / $9,786.11
| Facility | | $102.59 | $6,474.88 | $9,786.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,309.54 / $11,575.29 / $13,603.87
| Facility | | $8,309.54 | $11,575.29 | $13,603.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,499.36 / $12,346.74 / $15,564.07
| Facility | | $7,499.36 | $12,346.74 | $15,564.07 |