- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,689.52 / $8,110.53 / $9,350.95
| Facility | | $6,689.52 | $8,110.53 | $9,350.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,038.59 / $19,038.59 / $20,626.65
| Facility | | $19,038.59 | $19,038.59 | $20,626.65 |
- 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
- $5,950.80 / $9,472.03 / $16,256.97
| Facility | | $5,950.80 | $9,472.03 | $16,256.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $14,079.80
| Facility | | $2,332.00 | $5,310.00 | $14,079.80 |