- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,262.46 / $7,592.75 / $8,754.00
| Facility | | $6,262.46 | $7,592.75 | $8,754.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,633.13 / $7,633.13 / $15,790.30
| Facility | | $7,633.13 | $7,633.13 | $15,790.30 |
- 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
- $5,570.90 / $8,867.34 / $15,219.12
| Facility | | $5,570.90 | $8,867.34 | $15,219.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $13,180.94
| Facility | | $2,332.00 | $5,044.00 | $13,180.94 |