- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $9,772.37 / $11,220.18
| Facility | | $7,585.78 | $9,772.37 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $10,715.19 / $12,589.25
| Facility | | $8,709.64 | $10,715.19 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $8,912.51 / $10,715.19
| Facility | | $7,585.78 | $8,912.51 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $11,220.18 / $14,125.38
| Facility | | $6,918.31 | $11,220.18 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,302.69 / $14,454.40
| Facility | | $10,000.00 | $12,302.69 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $10,471.29 / $13,489.63
| Facility | | $1,513.56 | $10,471.29 | $13,489.63 |