- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,348.11 / $6,946.92 / $9,318.69
| Facility | | $3,348.11 | $6,946.92 | $9,318.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,832.31 / $9,489.10 / $15,309.50
| Facility | | $5,832.31 | $9,489.10 | $15,309.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $7,355.02 / $8,745.45
| Facility | | $2,651.00 | $7,355.02 | $8,745.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,904.88 / $7,173.45 / $11,290.79
| Facility | | $5,904.88 | $7,173.45 | $11,290.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $8,862.61
| Facility | | $1,350.00 | $5,372.00 | $8,862.61 |