- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,678.27 / $6,884.46 / $7,937.38
| Facility | | $5,678.27 | $6,884.46 | $7,937.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,076.71 / $8,662.28 / $11,246.64
| Facility | | $7,076.71 | $8,662.28 | $11,246.64 |
- 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
- $5,051.22 / $8,040.15 / $13,799.41
| Facility | | $5,051.22 | $8,040.15 | $13,799.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $11,951.36
| Facility | | $2,332.00 | $5,044.00 | $11,951.36 |