- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $9,332.54 / $9,772.37
| Facility | | $7,943.28 | $9,332.54 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $10,000.00 / $14,454.40
| Facility | | $5,754.40 | $10,000.00 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $8,317.64 / $14,791.08
| Facility | | $6,025.60 | $8,317.64 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $7,762.47 / $10,000.00
| Facility | | $6,918.31 | $7,762.47 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $9,332.54 / $15,135.61
| Facility | | $5,754.40 | $9,332.54 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $5,888.44 / $7,762.47
| Facility | | $66.07 | $5,888.44 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $10,715.19 / $11,220.18
| Facility | | $8,709.64 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $10,000.00 / $13,489.63
| Facility | | $5,754.40 | $10,000.00 | $13,489.63 |