- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,133.85 / $6,224.40 / $7,176.36
| Facility | | $5,133.85 | $6,224.40 | $7,176.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,145.97 / $8,145.97 / $8,145.97
| Facility | | $8,145.97 | $8,145.97 | $8,145.97 |
- 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
- $4,566.92 / $7,269.28 / $12,476.35
| Facility | | $4,566.92 | $7,269.28 | $12,476.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $10,805.49
| Facility | | $2,332.00 | $5,044.00 | $10,805.49 |