- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $9,332.54 / $13,489.63
| Facility | | $5,370.32 | $9,332.54 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,964.78 / $18,620.87
| Facility | | $6,456.54 | $10,964.78 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $9,120.11 / $15,135.61
| Facility | | $5,011.87 | $9,120.11 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $12,302.69
| Facility | | $10,000.00 | $10,000.00 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $10,000.00 / $12,882.50
| Facility | | $4,168.69 | $10,000.00 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,589.25 / $19,952.62
| Facility | | $10,000.00 | $12,589.25 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $8,912.51 / $13,182.57
| Facility | | $5,128.61 | $8,912.51 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $5,495.41 / $7,244.36
| Facility | | $4,570.88 | $5,495.41 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,162.28 / $6,918.31 / $12,022.64
| Facility | | $3,162.28 | $6,918.31 | $12,022.64 |