- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $7,244.36 / $9,549.93
| Facility | | $5,754.40 | $7,244.36 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $6,918.31 / $10,000.00
| Facility | | $4,570.88 | $6,918.31 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $5,623.41 / $9,120.11
| Facility | | $2,454.71 | $5,623.41 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,128.61 / $12,022.64
| Facility | | $3,801.89 | $5,128.61 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $8,709.64 / $12,022.64
| Facility | | $6,165.95 | $8,709.64 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $7,943.28 / $19,952.62
| Facility | | $3,630.78 | $7,943.28 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $7,079.46 / $9,549.93
| Facility | | $3,630.78 | $7,079.46 | $9,549.93 |