- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,665.40 / $8,081.28 / $9,317.24
| Facility | | $6,665.40 | $8,081.28 | $9,317.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,550.16 / $9,550.16 / $9,550.16
| Facility | | $9,550.16 | $9,550.16 | $9,550.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,929.34 / $9,437.87 / $16,198.34
| Facility | | $5,929.34 | $9,437.87 | $16,198.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $9,202.39 / $14,262.11
| Facility | | $3,137.00 | $9,202.39 | $14,262.11 |