- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,347.67 / $6,946.00 / $9,317.45
| Facility | | $3,347.67 | $6,946.00 | $9,317.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,850.39 / $4,850.39 / $4,850.39
| Facility | | $4,850.39 | $4,850.39 | $4,850.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $8,847.78 / $10,520.42
| Facility | | $2,651.00 | $8,847.78 | $10,520.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,904.10 / $7,172.50 / $11,289.30
| Facility | | $5,904.10 | $7,172.50 | $11,289.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $5,468.00 / $10,189.48
| Facility | | $1,500.00 | $5,468.00 | $10,189.48 |