- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,268.69 / $7,269.96 / $12,167.30
| Facility | | $5,268.69 | $7,269.96 | $12,167.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,066.34 / $12,066.34 / $12,066.34
| Facility | | $12,066.34 | $12,066.34 | $12,066.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $8,613.37 / $12,911.14
| Facility | | $2,423.00 | $8,613.37 | $12,911.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,392.46 / $8,179.01 / $13,716.16
| Facility | | $5,392.46 | $8,179.01 | $13,716.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,160.00 / $5,622.44 / $14,384.36
| Facility | | $2,160.00 | $5,622.44 | $14,384.36 |