- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,796.76 / $5,815.71 / $6,705.17
| Facility | | $4,796.76 | $5,815.71 | $6,705.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,566.57 / $11,159.33 / $12,627.22
| Facility | | $7,566.57 | $11,159.33 | $12,627.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,267.06 / $6,791.98 / $11,657.17
| Facility | | $4,267.06 | $6,791.98 | $11,657.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $10,096.01
| Facility | | $2,332.00 | $5,044.00 | $10,096.01 |