- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $10,000.00 / $11,481.54
| Facility | | $7,762.47 | $10,000.00 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,715.35 / $4,786.30
| Facility | | $1,047.13 | $3,715.35 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $7,762.47 / $9,332.54
| Facility | | $6,606.93 | $7,762.47 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $13,803.84 / $13,803.84
| Facility | | $13,803.84 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $4,265.80 / $5,495.41
| Facility | | $1,202.26 | $4,265.80 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $10,471.29 / $13,489.63
| Facility | | $1,513.56 | $10,471.29 | $13,489.63 |