- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,456.75 / $7,172.32 / $9,621.04
| Facility | | $3,456.75 | $7,172.32 | $9,621.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,696.97 / $7,641.65 / $10,520.09
| Facility | | $3,696.97 | $7,641.65 | $10,520.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $5,170.00 / $5,170.00
| Facility | | $2,651.00 | $5,170.00 | $5,170.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,096.47 / $7,406.20 / $11,657.13
| Facility | | $6,096.47 | $7,406.20 | $11,657.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,468.00 / $9,150.17
| Facility | | $1,350.00 | $5,468.00 | $9,150.17 |