- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,504.02 / $9,504.02 / $11,264.10
| Facility | | $9,504.02 | $9,504.02 | $11,264.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,185.48 / $11,691.16 / $17,489.25
| Facility | | $7,185.48 | $11,691.16 | $17,489.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,773.11 / $9,620.87 / $16,368.80
| Facility | | $7,773.11 | $9,620.87 | $16,368.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,954.47 / $11,158.47 / $18,264.80
| Facility | | $6,954.47 | $11,158.47 | $18,264.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.70 / $6,671.15 / $9,531.46
| Facility | | $105.70 | $6,671.15 | $9,531.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,913.85 / $11,024.09 / $12,956.07
| Facility | | $7,913.85 | $11,024.09 | $12,956.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,142.24 / $11,758.80 / $14,822.93
| Facility | | $7,142.24 | $11,758.80 | $14,822.93 |