- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $7,079.46 / $11,748.98
| Facility | | $3,388.44 | $7,079.46 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,413.10 / $18,620.87
| Facility | | $4,570.88 | $7,413.10 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $6,760.83 / $10,232.93
| Facility | | $3,981.07 | $6,760.83 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $10,000.00
| Facility | | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,606.93 / $17,378.01
| Facility | | $4,570.88 | $6,606.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,413.10 / $18,620.87
| Facility | | $4,570.88 | $7,413.10 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $6,165.95 / $15,135.61
| Facility | | $3,890.45 | $6,165.95 | $15,135.61 |