- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $8,709.64 / $10,000.00
| Facility | | $6,760.83 | $8,709.64 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $4,786.30 / $8,912.51
| Facility | | $3,630.78 | $4,786.30 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,413.10 / $9,120.11
| Facility | | $6,309.57 | $7,413.10 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $12,302.69 / $12,302.69
| Facility | | $12,302.69 | $12,302.69 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,495.41 / $10,232.93
| Facility | | $4,168.69 | $5,495.41 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $9,120.11 / $11,748.98
| Facility | | $1,513.56 | $9,120.11 | $11,748.98 |