- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,877.67 / $5,970.80 / $8,009.31
| Facility | | $2,877.67 | $5,970.80 | $8,009.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,284.19 / $14,284.19 / $14,284.19
| Facility | | $14,284.19 | $14,284.19 | $14,284.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $6,680.30 / $7,943.18
| Facility | | $2,651.00 | $6,680.30 | $7,943.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,075.18 / $6,165.50 / $9,704.31
| Facility | | $5,075.18 | $6,165.50 | $9,704.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $7,617.31
| Facility | | $1,350.00 | $5,372.00 | $7,617.31 |