- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,149.50 / $6,243.37 / $7,198.24
| Facility | | $5,149.50 | $6,243.37 | $7,198.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,407.04 / $6,407.04 / $7,584.41
| Facility | | $6,407.04 | $6,407.04 | $7,584.41 |
- 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
- $4,580.84 / $7,291.43 / $12,514.38
| Facility | | $4,580.84 | $7,291.43 | $12,514.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $10,838.43
| Facility | | $2,332.00 | $5,044.00 | $10,838.43 |