- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,280.72 / $7,614.89 / $8,779.52
| Facility | | $6,280.72 | $7,614.89 | $8,779.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,691.47 / $7,691.47 / $8,814.89
| Facility | | $7,691.47 | $7,691.47 | $8,814.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,587.14 / $8,893.19 / $15,263.49
| Facility | | $5,587.14 | $8,893.19 | $15,263.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,057.33 / $13,219.37
| Facility | | $2,332.00 | $5,057.33 | $13,219.37 |