- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,024.43 / $6,275.32 / $8,417.79
| Facility | | $3,024.43 | $6,275.32 | $8,417.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,685.82 / $6,685.82 / $6,685.82
| Facility | | $6,685.82 | $6,685.82 | $6,685.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $6,524.71 / $7,758.18
| Facility | | $2,651.00 | $6,524.71 | $7,758.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,334.02 / $6,479.95 / $10,199.24
| Facility | | $5,334.02 | $6,479.95 | $10,199.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $8,005.81
| Facility | | $1,350.00 | $5,372.00 | $8,005.81 |