- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,764.47 / $7,810.80 / $10,477.50
| Facility | | $3,764.47 | $7,810.80 | $10,477.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,969.32 / $10,660.53 / $11,069.00
| Facility | | $7,969.32 | $10,660.53 | $11,069.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $9,094.68 / $10,814.00
| Facility | | $2,651.00 | $9,094.68 | $10,814.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,639.18 / $8,065.50 / $12,694.85
| Facility | | $6,639.18 | $8,065.50 | $12,694.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,603.40 / $10,156.59
| Facility | | $1,350.00 | $5,603.40 | $10,156.59 |