- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,923.25 / $5,969.07 / $6,881.98
| Facility | | $4,923.25 | $5,969.07 | $6,881.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,449.42 / $9,692.65 / $14,722.65
| Facility | | $6,449.42 | $9,692.65 | $14,722.65 |
- 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
- $4,379.58 / $6,971.08 / $11,964.56
| Facility | | $4,379.58 | $6,971.08 | $11,964.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,121.00 / $10,362.24
| Facility | | $2,332.00 | $5,121.00 | $10,362.24 |