- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,707.94 / $9,345.29 / $10,774.60
| Facility | | $7,707.94 | $9,345.29 | $10,774.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,587.56 / $10,587.56 / $10,587.56
| Facility | | $10,587.56 | $10,587.56 | $10,587.56 |
- 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
- $6,856.76 / $10,914.07 / $18,731.96
| Facility | | $6,856.76 | $10,914.07 | $18,731.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $16,223.33
| Facility | | $2,332.00 | $5,310.00 | $16,223.33 |