- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $10,715.19 / $11,220.18
| Facility | | $9,120.11 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $11,481.54 / $16,595.87
| Facility | | $6,606.93 | $11,481.54 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $9,549.93 / $16,982.44
| Facility | | $6,918.31 | $9,549.93 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $8,912.51 / $11,481.54
| Facility | | $7,943.28 | $8,912.51 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,715.19 / $17,378.01
| Facility | | $6,606.93 | $10,715.19 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75.86 / $6,760.83 / $8,912.51
| Facility | | $75.86 | $6,760.83 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,302.69 / $12,882.50
| Facility | | $10,000.00 | $12,302.69 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $11,481.54 / $15,488.17
| Facility | | $6,606.93 | $11,481.54 | $15,488.17 |