- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,034.63 / $6,296.48 / $8,446.18
| Facility | | $3,034.63 | $6,296.48 | $8,446.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,435.62 / $7,002.13 / $15,552.42
| Facility | | $6,435.62 | $7,002.13 | $15,552.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $6,641.00 / $7,896.46
| Facility | | $2,651.00 | $6,641.00 | $7,896.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,352.01 / $6,501.80 / $10,233.62
| Facility | | $5,352.01 | $6,501.80 | $10,233.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,468.00 / $8,032.80
| Facility | | $1,350.00 | $5,468.00 | $8,032.80 |