- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $8,709.64 / $10,471.29
| Facility | | $7,244.36 | $8,709.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $7,943.28 / $12,589.25
| Facility | | $7,762.47 | $7,943.28 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $8,912.51 / $14,125.38
| Facility | | $6,918.31 | $8,912.51 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $12,302.69 / $12,302.69
| Facility | | $5,623.41 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,000.00 / $15,135.61
| Facility | | $7,244.36 | $10,000.00 | $15,135.61 |