- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,000.00 / $19,498.45
| Facility | | $7,762.47 | $10,000.00 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $8,912.51 / $15,135.61
| Facility | | $3,801.89 | $8,912.51 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $10,232.93 / $14,125.38
| Facility | | $7,585.78 | $10,232.93 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $9,772.37 / $15,848.93
| Facility | | $4,897.79 | $9,772.37 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $9,120.11 / $13,489.63
| Facility | | $6,309.57 | $9,120.11 | $13,489.63 |