- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,806.40 / $12,806.40 / $15,178.10
| Facility | | $12,806.40 | $12,806.40 | $15,178.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,118.60 / $14,836.46 / $22,194.44
| Facility | | $9,118.60 | $14,836.46 | $22,194.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,474.02 / $12,963.82 / $22,056.44
| Facility | | $10,474.02 | $12,963.82 | $22,056.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,370.93 / $15,035.68 / $24,611.24
| Facility | | $9,370.93 | $15,035.68 | $24,611.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $134.13 / $8,465.91 / $12,558.55
| Facility | | $134.13 | $8,465.91 | $12,558.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,663.66 / $14,854.61 / $17,457.89
| Facility | | $10,663.66 | $14,854.61 | $17,457.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,623.95 / $15,844.61 / $19,973.43
| Facility | | $9,623.95 | $15,844.61 | $19,973.43 |