- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $9,549.93 / $14,125.38
| Facility | | $6,456.54 | $9,549.93 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $7,762.47 / $11,748.98
| Facility | | $5,370.32 | $7,762.47 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $9,549.93 / $13,489.63
| Facility | | $6,025.60 | $9,549.93 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $7,762.47 / $12,882.50
| Facility | | $5,888.44 | $7,762.47 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $6,025.60 / $10,000.00
| Facility | | $3,801.89 | $6,025.60 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $10,000.00 / $13,803.84
| Facility | | $5,011.87 | $10,000.00 | $13,803.84 |