- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,026.44 / $7,306.59 / $8,424.07
| Facility | | $6,026.44 | $7,306.59 | $8,424.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,207.70 / $8,207.70 / $8,207.70
| Facility | | $8,207.70 | $8,207.70 | $8,207.70 |
- 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
- $5,360.94 / $8,533.14 / $14,645.53
| Facility | | $5,360.94 | $8,533.14 | $14,645.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $12,684.17
| Facility | | $2,332.00 | $5,044.00 | $12,684.17 |