- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,851.40 / $10,851.40 / $12,861.10
| Facility | | $10,851.40 | $10,851.40 | $12,861.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,144.41 / $13,251.40 / $19,823.29
| Facility | | $8,144.41 | $13,251.40 | $19,823.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,875.12 / $10,984.84 / $18,689.43
| Facility | | $8,875.12 | $10,984.84 | $18,689.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,940.42 / $12,740.43 / $20,854.24
| Facility | | $7,940.42 | $12,740.43 | $20,854.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $119.81 / $7,561.45 / $10,803.49
| Facility | | $119.81 | $7,561.45 | $10,803.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,035.81 / $12,587.00 / $14,792.88
| Facility | | $9,035.81 | $12,587.00 | $14,792.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,154.82 / $13,425.87 / $16,924.41
| Facility | | $8,154.82 | $13,425.87 | $16,924.41 |