- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,694.39 / $5,691.60 / $6,562.08
| Facility | | $4,694.39 | $5,691.60 | $6,562.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,522.97 / $7,108.19 / $11,674.78
| Facility | | $4,522.97 | $7,108.19 | $11,674.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,176.00 / $6,647.04 / $11,408.40
| Facility | | $4,176.00 | $6,647.04 | $11,408.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $9,880.56
| Facility | | $2,332.00 | $5,044.00 | $9,880.56 |