- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,096.68 / $6,179.34 / $7,124.41
| Facility | | $5,096.68 | $6,179.34 | $7,124.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,974.84 / $6,100.64 / $7,769.28
| Facility | | $5,974.84 | $6,100.64 | $7,769.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,533.85 / $7,216.65 / $12,386.04
| Facility | | $4,533.85 | $7,216.65 | $12,386.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,156.00 / $5,121.00 / $10,934.42
| Facility | | $2,156.00 | $5,121.00 | $10,934.42 |