- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,037.90 / $12,037.90 / $14,267.30
| Facility | | $12,037.90 | $12,037.90 | $14,267.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,657.66 / $14,086.48 / $21,072.52
| Facility | | $8,657.66 | $14,086.48 | $21,072.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,845.53 / $12,185.93 / $20,732.95
| Facility | | $9,845.53 | $12,185.93 | $20,732.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,808.62 / $14,133.47 / $23,134.45
| Facility | | $8,808.62 | $14,133.47 | $23,134.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $127.36 / $8,037.96 / $11,804.97
| Facility | | $127.36 | $8,037.96 | $11,804.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,023.79 / $13,963.27 / $16,410.34
| Facility | | $10,023.79 | $13,963.27 | $16,410.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,046.46 / $14,893.86 / $18,774.93
| Facility | | $9,046.46 | $14,893.86 | $18,774.93 |