- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,019.79 / $10,019.79 / $11,875.50
| Facility | | $10,019.79 | $10,019.79 | $11,875.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,236.69 / $11,774.49 / $17,613.91
| Facility | | $7,236.69 | $11,774.49 | $17,613.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,194.98 / $10,143.02 / $17,257.16
| Facility | | $8,194.98 | $10,143.02 | $17,257.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,331.91 / $11,764.06 / $19,256.07
| Facility | | $7,331.91 | $11,764.06 | $19,256.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.46 / $6,718.70 / $9,825.93
| Facility | | $106.46 | $6,718.70 | $9,825.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,343.35 / $11,622.39 / $13,659.22
| Facility | | $8,343.35 | $11,622.39 | $13,659.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,529.87 / $12,396.98 / $15,627.40
| Facility | | $7,529.87 | $12,396.98 | $15,627.40 |