- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $10,964.78 / $13,182.57
| Facility | | $9,120.11 | $10,964.78 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $10,000.00 / $15,848.93
| Facility | | $9,772.37 | $10,000.00 | $15,848.93 |
- 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
- $8,709.64 / $11,220.18 / $17,782.79
| Facility | | $8,709.64 | $11,220.18 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $15,848.93 / $15,848.93
| Facility | | $7,413.10 | $15,848.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,589.25 / $18,620.87
| Facility | | $9,120.11 | $12,589.25 | $18,620.87 |