- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,471.29 / $13,803.84
| Facility | | $6,456.54 | $10,471.29 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $13,182.57 / $15,135.61
| Facility | | $13,182.57 | $13,182.57 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $12,882.50 / $16,218.10
| Facility | | $8,912.51 | $12,882.50 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $12,302.69
| Facility | | $12,302.69 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,000.00 / $13,182.57
| Facility | | $6,606.93 | $10,000.00 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $12,302.69
| Facility | | $12,302.69 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $9,120.11 / $14,125.38
| Facility | | $5,754.40 | $9,120.11 | $14,125.38 |