- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $9,549.93 / $12,302.69
| Facility | | $8,128.31 | $9,549.93 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $9,772.37 / $16,595.87
| Facility | | $4,168.69 | $9,772.37 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $11,481.54 / $16,595.87
| Facility | | $8,709.64 | $11,481.54 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $10,964.78 / $17,378.01
| Facility | | $5,495.41 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $10,000.00 / $15,135.61
| Facility | | $6,918.31 | $10,000.00 | $15,135.61 |