- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,000.00 / $15,135.61
| Facility | | $7,762.47 | $10,000.00 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,905.46 / $7,585.78 / $19,952.62
| Facility | | $1,905.46 | $7,585.78 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $9,772.37 / $14,454.40
| Facility | | $5,128.61 | $9,772.37 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $7,943.28 / $14,791.08
| Facility | | $5,754.40 | $7,943.28 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $8,511.38 / $12,022.64
| Facility | | $3,090.30 | $8,511.38 | $12,022.64 |