- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,193.05 / $7,287.25 / $11,447.30
| Facility | | $5,193.05 | $7,287.25 | $11,447.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,827.43 / $6,827.43 / $6,827.43
| Facility | | $6,827.43 | $6,827.43 | $6,827.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,226.88 / $6,586.47 / $10,688.39
| Facility | | $4,226.88 | $6,586.47 | $10,688.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,530.26 / $6,254.30 / $11,320.00
| Facility | | $4,530.26 | $6,254.30 | $11,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48.15 / $71.41 / $120.00
| Facility | | $48.15 | $71.41 | $120.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.85 / $6,905.77 / $11,365.28
| Facility | | $4,989.85 | $6,905.77 | $11,365.28 |