- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,016.68 / $6,922.24 / $11,585.40
| Facility | | $5,016.68 | $6,922.24 | $11,585.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,968.02 / $8,968.02 / $8,968.02
| Facility | | $8,968.02 | $8,968.02 | $8,968.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $7,750.97 / $12,007.41
| Facility | | $2,423.00 | $7,750.97 | $12,007.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,134.54 / $7,787.81 / $13,060.12
| Facility | | $5,134.54 | $7,787.81 | $13,060.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $6,285.20 / $13,975.86
| Facility | | $2,600.00 | $6,285.20 | $13,975.86 |