- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,332.59 / $6,914.72 / $9,275.50
| Facility | | $3,332.59 | $6,914.72 | $9,275.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,817.38 / $15,817.38 / $15,817.38
| Facility | | $15,817.38 | $15,817.38 | $15,817.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $5,889.28 / $7,002.63
| Facility | | $2,651.00 | $5,889.28 | $7,002.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,877.51 / $7,140.20 / $11,238.46
| Facility | | $5,877.51 | $7,140.20 | $11,238.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $8,821.53
| Facility | | $1,350.00 | $5,372.00 | $8,821.53 |