- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $10,471.29 / $14,791.08
| Facility | | $5,888.44 | $10,471.29 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,589.25 / $20,417.38
| Facility | | $7,762.47 | $12,589.25 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $10,000.00 / $16,595.87
| Facility | | $5,623.41 | $10,000.00 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $10,964.78 / $13,489.63
| Facility | | $10,964.78 | $10,964.78 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $10,964.78 / $14,125.38
| Facility | | $4,570.88 | $10,964.78 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $12,302.69
| Facility | | $10,000.00 | $10,000.00 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $9,772.37 / $14,454.40
| Facility | | $5,623.41 | $9,772.37 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $5,370.32 / $8,709.64
| Facility | | $4,168.69 | $5,370.32 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $7,585.78 / $13,182.57
| Facility | | $3,548.13 | $7,585.78 | $13,182.57 |