- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,361.12 / $8,361.12 / $9,909.59
| Facility | | $8,361.12 | $8,361.12 | $9,909.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.59 / $10,052.91 / $15,038.54
| Facility | | $6,178.59 | $10,052.91 | $15,038.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,838.37 / $8,463.93 / $14,400.40
| Facility | | $6,838.37 | $8,463.93 | $14,400.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,118.17 / $9,816.62 / $16,068.40
| Facility | | $6,118.17 | $9,816.62 | $16,068.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $90.89 / $5,736.34 / $8,199.33
| Facility | | $90.89 | $5,736.34 | $8,199.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,962.18 / $9,698.41 / $11,398.06
| Facility | | $6,962.18 | $9,698.41 | $11,398.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,283.37 / $10,344.77 / $13,040.42
| Facility | | $6,283.37 | $10,344.77 | $13,040.42 |