- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,715.19 / $15,488.17
| Facility | | $7,244.36 | $10,715.19 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $7,244.36 / $9,772.37
| Facility | | $7,244.36 | $7,244.36 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $11,220.18 / $19,054.61
| Facility | | $4,168.69 | $11,220.18 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $8,912.51 / $14,791.08
| Facility | | $6,456.54 | $8,912.51 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $10,000.00 / $14,454.40
| Facility | | $7,943.28 | $10,000.00 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $9,549.93 / $14,125.38
| Facility | | $5,370.32 | $9,549.93 | $14,125.38 |