- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,656.92 / $8,071.01 / $9,305.39
| Facility | | $6,656.92 | $8,071.01 | $9,305.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,327.91 / $9,327.91 / $12,807.35
| Facility | | $9,327.91 | $9,327.91 | $12,807.35 |
- 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
- $5,921.80 / $9,425.87 / $16,177.75
| Facility | | $5,921.80 | $9,425.87 | $16,177.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,307.16 / $14,011.18
| Facility | | $2,332.00 | $5,307.16 | $14,011.18 |