- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,363.52 / $7,715.28 / $8,895.26
| Facility | | $6,363.52 | $7,715.28 | $8,895.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,071.86 / $15,071.86 / $15,071.86
| Facility | | $15,071.86 | $15,071.86 | $15,071.86 |
- 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
- $5,660.80 / $9,010.43 / $15,464.72
| Facility | | $5,660.80 | $9,010.43 | $15,464.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,121.00 / $13,393.65
| Facility | | $2,332.00 | $5,121.00 | $13,393.65 |