- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,682.57 / $5,566.00 / $7,466.31
| Facility | | $2,682.57 | $5,566.00 | $7,466.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,564.50 / $4,564.50 / $5,871.04
| Facility | | $4,564.50 | $4,564.50 | $5,871.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $5,883.60 / $6,995.88
| Facility | | $2,651.00 | $5,883.60 | $6,995.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,731.10 / $5,747.50 / $9,046.39
| Facility | | $4,731.10 | $5,747.50 | $9,046.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $7,100.89
| Facility | | $1,350.00 | $5,372.00 | $7,100.89 |