- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,750.81 / $8,184.84 / $9,436.64
| Facility | | $6,750.81 | $8,184.84 | $9,436.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,266.75 / $8,266.75 / $10,290.79
| Facility | | $8,266.75 | $8,266.75 | $10,290.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,715.00 / $8,731.00
| Facility | | $1,252.00 | $3,715.00 | $8,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,005.32 / $9,558.81 / $16,405.91
| Facility | | $6,005.32 | $9,558.81 | $16,405.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,137.00 / $9,541.20 / $14,444.87
| Facility | | $3,137.00 | $9,541.20 | $14,444.87 |