- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $11,481.54 / $13,803.84
| Facility | | $9,332.54 | $11,481.54 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,232.93 / $16,595.87
| Facility | | $10,000.00 | $10,232.93 | $16,595.87 |
- 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
- $8,912.51 / $11,481.54 / $18,197.01
| Facility | | $8,912.51 | $11,481.54 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $15,135.61 / $15,135.61
| Facility | | $7,413.10 | $15,135.61 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,882.50 / $19,498.45
| Facility | | $9,332.54 | $12,882.50 | $19,498.45 |