- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,997.10 / $7,271.02 / $8,383.06
| Facility | | $5,997.10 | $7,271.02 | $8,383.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,791.63 / $7,791.63 / $12,814.54
| Facility | | $7,791.63 | $7,791.63 | $12,814.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,334.84 / $8,491.59 / $14,574.23
| Facility | | $5,334.84 | $8,491.59 | $14,574.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $12,622.42
| Facility | | $2,332.00 | $5,044.00 | $12,622.42 |