- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,267.68 / $7,599.08 / $8,761.29
| Facility | | $6,267.68 | $7,599.08 | $8,761.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,441.20 / $9,603.15 / $19,994.40
| Facility | | $4,441.20 | $9,603.15 | $19,994.40 |
- 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
- $5,575.54 / $8,874.71 / $15,231.80
| Facility | | $5,575.54 | $8,874.71 | $15,231.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,046.83 / $13,191.92
| Facility | | $2,332.00 | $5,046.83 | $13,191.92 |