- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,843.22 / $7,084.46 / $8,167.97
| Facility | | $5,843.22 | $7,084.46 | $8,167.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,304.36 / $9,225.79 / $14,914.79
| Facility | | $8,304.36 | $9,225.79 | $14,914.79 |
- 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
- $5,197.96 / $8,273.71 / $14,200.29
| Facility | | $5,197.96 | $8,273.71 | $14,200.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $12,298.55
| Facility | | $2,332.00 | $5,044.00 | $12,298.55 |