- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,009.32 / $6,073.41 / $7,002.29
| Facility | | $5,009.32 | $6,073.41 | $7,002.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,409.65 / $7,409.65 / $10,733.38
| Facility | | $7,409.65 | $7,409.65 | $10,733.38 |
- 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
- $4,456.14 / $7,092.95 / $12,173.71
| Facility | | $4,456.14 | $7,092.95 | $12,173.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $10,543.38
| Facility | | $2,332.00 | $5,044.00 | $10,543.38 |