- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,289.02 / $6,412.54 / $7,393.28
| Facility | | $5,289.02 | $6,412.54 | $7,393.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,322.12 / $7,623.44 / $8,488.94
| Facility | | $7,322.12 | $7,623.44 | $8,488.94 |
- 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
- $4,704.96 / $7,489.00 / $12,853.46
| Facility | | $4,704.96 | $7,489.00 | $12,853.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $11,132.10
| Facility | | $2,332.00 | $5,044.00 | $11,132.10 |