- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,125.50 / $7,894.93 / $16,044.60
| Facility | | $6,125.50 | $7,894.93 | $16,044.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,137.30 / $4,137.30 / $4,137.30
| Facility | | $4,137.30 | $4,137.30 | $4,137.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,217.47 / $7,793.73 / $8,910.25
| Facility | | $6,217.47 | $7,793.73 | $8,910.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,889.46 / $8,654.85 / $11,256.01
| Facility | | $4,889.46 | $8,654.85 | $11,256.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,757.89 / $4,757.89 / $4,757.89
| Facility | | $4,757.89 | $4,757.89 | $4,757.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,286.00 / $6,940.98 / $10,689.27
| Facility | | $1,286.00 | $6,940.98 | $10,689.27 |