- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,406.64 / $7,068.36 / $9,481.59
| Facility | | $3,406.64 | $7,068.36 | $9,481.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,796.68 / $9,796.68 / $9,796.68
| Facility | | $9,796.68 | $9,796.68 | $9,796.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $6,104.72 / $7,258.80
| Facility | | $2,651.00 | $6,104.72 | $7,258.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,008.11 / $7,298.85 / $11,488.17
| Facility | | $6,008.11 | $7,298.85 | $11,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $9,017.54
| Facility | | $1,350.00 | $5,372.00 | $9,017.54 |