- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $11,748.98 / $15,135.61
| Facility | | $7,943.28 | $11,748.98 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $4,677.35 / $10,000.00
| Facility | | $2,511.89 | $4,677.35 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,754.40 / $10,715.19
| Facility | | $4,168.69 | $5,754.40 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,754.40 / $10,715.19
| Facility | | $4,168.69 | $5,754.40 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $7,244.36 / $11,748.98
| Facility | | $3,090.30 | $7,244.36 | $11,748.98 |