- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,669.96 / $8,086.81 / $9,323.62
| Facility | | $6,669.96 | $8,086.81 | $9,323.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,487.11 / $9,487.11 / $9,487.11
| Facility | | $9,487.11 | $9,487.11 | $9,487.11 |
- 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
- $5,933.40 / $9,444.34 / $16,209.44
| Facility | | $5,933.40 | $9,444.34 | $16,209.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $14,038.63
| Facility | | $2,332.00 | $5,310.00 | $14,038.63 |