- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,254.47 / $6,370.64 / $7,344.97
| Facility | | $5,254.47 | $6,370.64 | $7,344.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,198.83 / $8,104.61 / $13,453.55
| Facility | | $5,198.83 | $8,104.61 | $13,453.55 |
- 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
- $4,674.22 / $7,440.07 / $12,769.49
| Facility | | $4,674.22 | $7,440.07 | $12,769.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $11,059.37
| Facility | | $2,332.00 | $5,044.00 | $11,059.37 |