- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $9,549.93 / $10,964.78
| Facility | | $7,413.10 | $9,549.93 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $10,000.00 / $15,848.93
| Facility | | $7,079.46 | $10,000.00 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $8,511.38 / $10,232.93
| Facility | | $7,244.36 | $8,511.38 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,715.19 / $13,489.63
| Facility | | $6,606.93 | $10,715.19 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $11,481.54 / $18,620.87
| Facility | | $8,128.31 | $11,481.54 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $10,000.00 / $12,882.50
| Facility | | $1,513.56 | $10,000.00 | $12,882.50 |