- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,668.25 / $7,611.16 / $10,209.70
| Facility | | $3,668.25 | $7,611.16 | $10,209.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,787.55 / $3,787.55 / $8,357.25
| Facility | | $3,787.55 | $3,787.55 | $8,357.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $7,319.92 / $8,703.73
| Facility | | $2,651.00 | $7,319.92 | $8,703.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,469.49 / $7,859.35 / $12,370.38
| Facility | | $6,469.49 | $7,859.35 | $12,370.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,460.18 / $9,710.02
| Facility | | $1,350.00 | $5,460.18 | $9,710.02 |