- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,265.55 / $6,384.08 / $7,360.47
| Facility | | $5,265.55 | $6,384.08 | $7,360.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,203.41 / $5,203.41 / $5,203.41
| Facility | | $5,203.41 | $5,203.41 | $5,203.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,684.08 / $7,455.76 / $12,796.42
| Facility | | $4,684.08 | $7,455.76 | $12,796.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $11,082.69
| Facility | | $2,332.00 | $5,044.00 | $11,082.69 |