- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $8,317.64 / $10,715.19
| Facility | | $7,244.36 | $8,317.64 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,079.46 / $14,791.08
| Facility | | $6,309.57 | $7,079.46 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,715.35 / $8,709.64 / $14,791.08
| Facility | | $3,715.35 | $8,709.64 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,000.00 / $15,848.93
| Facility | | $7,762.47 | $10,000.00 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $9,549.93 / $15,488.17
| Facility | | $4,786.30 | $9,549.93 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $9,120.11 / $13,182.57
| Facility | | $6,165.95 | $9,120.11 | $13,182.57 |