- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,484.62 / $6,649.69 / $7,666.70
| Facility | | $5,484.62 | $6,649.69 | $7,666.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,014.08 / $8,033.42 / $15,380.75
| Facility | | $7,014.08 | $8,033.42 | $15,380.75 |
- 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
- $4,878.96 / $7,765.96 / $13,328.81
| Facility | | $4,878.96 | $7,765.96 | $13,328.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $11,543.79
| Facility | | $2,332.00 | $5,044.00 | $11,543.79 |