- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,589.32 / $7,447.40 / $9,990.04
| Facility | | $3,589.32 | $7,447.40 | $9,990.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,900.13 / $7,504.32 / $10,011.04
| Facility | | $3,900.13 | $7,504.32 | $10,011.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $5,520.41 / $6,564.02
| Facility | | $2,651.00 | $5,520.41 | $6,564.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,330.29 / $7,690.25 / $12,104.22
| Facility | | $6,330.29 | $7,690.25 | $12,104.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $9,501.10
| Facility | | $1,350.00 | $5,372.00 | $9,501.10 |