- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,676.31 / $6,882.09 / $7,934.65
| Facility | | $5,676.31 | $6,882.09 | $7,934.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,766.80 / $13,766.80 / $13,766.80
| Facility | | $13,766.80 | $13,766.80 | $13,766.80 |
- 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
- $5,049.47 / $8,037.38 / $13,794.66
| Facility | | $5,049.47 | $8,037.38 | $13,794.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $8,022.58 / $12,145.74
| Facility | | $3,137.00 | $8,022.58 | $12,145.74 |