- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,682.83 / $6,890.00 / $7,943.76
| Facility | | $5,682.83 | $6,890.00 | $7,943.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,568.86 / $8,568.86 / $9,010.28
| Facility | | $8,568.86 | $8,568.86 | $9,010.28 |
- 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
- $5,055.28 / $8,046.61 / $13,810.50
| Facility | | $5,055.28 | $8,046.61 | $13,810.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $11,960.97
| Facility | | $2,332.00 | $5,044.00 | $11,960.97 |