- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,439.35 / $9,439.35 / $11,187.50
| Facility | | $9,439.35 | $9,439.35 | $11,187.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,386.73 / $10,391.54 / $15,545.13
| Facility | | $6,386.73 | $10,391.54 | $15,545.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,720.23 / $9,555.41 / $16,257.43
| Facility | | $7,720.23 | $9,555.41 | $16,257.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,907.15 / $11,082.55 / $18,140.53
| Facility | | $6,907.15 | $11,082.55 | $18,140.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93.95 / $5,929.57 / $9,256.69
| Facility | | $93.95 | $5,929.57 | $9,256.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,860.00 / $10,949.08 / $12,867.92
| Facility | | $7,860.00 | $10,949.08 | $12,867.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,093.65 / $11,678.80 / $14,722.08
| Facility | | $7,093.65 | $11,678.80 | $14,722.08 |