- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,148.89 / $8,608.44 / $11,547.50
| Facility | | $4,148.89 | $8,608.44 | $11,547.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,727.81 / $9,218.37 / $12,662.50
| Facility | | $4,727.81 | $9,218.37 | $12,662.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $8,165.11 / $9,708.70
| Facility | | $2,651.00 | $8,165.11 | $9,708.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,317.17 / $8,889.15 / $13,991.25
| Facility | | $7,317.17 | $8,889.15 | $13,991.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $10,982.31
| Facility | | $1,350.00 | $5,713.00 | $10,982.31 |