- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,773.30 / $12,773.30 / $15,138.90
| Facility | | $12,773.30 | $12,773.30 | $15,138.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,923.54 / $14,519.09 / $21,719.68
| Facility | | $8,923.54 | $14,519.09 | $21,719.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,446.96 / $12,930.33 / $21,999.46
| Facility | | $10,446.96 | $12,930.33 | $21,999.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,346.71 / $14,996.84 / $24,547.66
| Facility | | $9,346.71 | $14,996.84 | $24,547.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $131.27 / $8,284.81 / $12,526.10
| Facility | | $131.27 | $8,284.81 | $12,526.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,636.11 / $14,816.24 / $17,412.79
| Facility | | $10,636.11 | $14,816.24 | $17,412.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,599.09 / $15,803.68 / $19,921.83
| Facility | | $9,599.09 | $15,803.68 | $19,921.83 |