- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.23 / $6,652.52 / $8,923.78
| Facility | | $3,206.23 | $6,652.52 | $8,923.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,784.05 / $7,101.07 / $15,296.52
| Facility | | $3,784.05 | $7,101.07 | $15,296.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $8,264.94 / $9,827.40
| Facility | | $2,651.00 | $8,264.94 | $9,827.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,654.64 / $6,869.45 / $10,812.30
| Facility | | $5,654.64 | $6,869.45 | $10,812.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,468.00 / $8,650.45
| Facility | | $1,350.00 | $5,468.00 | $8,650.45 |