- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,262.09 / $6,768.44 / $9,079.27
| Facility | | $3,262.09 | $6,768.44 | $9,079.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,935.67 / $7,023.35 / $8,474.62
| Facility | | $3,935.67 | $7,023.35 | $8,474.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $6,839.07 / $8,131.97
| Facility | | $2,651.00 | $6,839.07 | $8,131.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,753.17 / $6,989.15 / $11,000.71
| Facility | | $5,753.17 | $6,989.15 | $11,000.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $8,634.91
| Facility | | $1,350.00 | $5,372.00 | $8,634.91 |