- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,208.18 / $6,314.51 / $7,280.26
| Facility | | $5,208.18 | $6,314.51 | $7,280.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,985.76 / $7,868.63 / $13,038.21
| Facility | | $6,985.76 | $7,868.63 | $13,038.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,633.04 / $7,374.52 / $12,656.99
| Facility | | $4,633.04 | $7,374.52 | $12,656.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $10,961.93
| Facility | | $2,332.00 | $5,044.00 | $10,961.93 |