- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,352.20 / $10,352.20 / $12,269.40
| Facility | | $10,352.20 | $10,352.20 | $12,269.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,493.86 / $12,192.92 / $18,239.86
| Facility | | $7,493.86 | $12,192.92 | $18,239.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,466.79 / $10,479.44 / $17,829.56
| Facility | | $8,466.79 | $10,479.44 | $17,829.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,575.09 / $12,154.25 / $19,894.75
| Facility | | $7,575.09 | $12,154.25 | $19,894.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.24 / $6,957.46 / $10,151.83
| Facility | | $110.24 | $6,957.46 | $10,151.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,620.08 / $12,007.89 / $14,112.28
| Facility | | $8,620.08 | $12,007.89 | $14,112.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,779.62 / $12,808.16 / $16,145.73
| Facility | | $7,779.62 | $12,808.16 | $16,145.73 |