- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,049.13 / $8,401.44 / $11,269.80
| Facility | | $4,049.13 | $8,401.44 | $11,269.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,158.36 / $7,158.36 / $7,158.36
| Facility | | $7,158.36 | $7,158.36 | $7,158.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $6,867.35 / $8,165.59
| Facility | | $2,651.00 | $6,867.35 | $8,165.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,141.22 / $8,675.40 / $13,654.81
| Facility | | $7,141.22 | $8,675.40 | $13,654.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $10,718.23
| Facility | | $1,350.00 | $5,713.00 | $10,718.23 |