- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,268.64 / $5,175.39 / $5,966.94
| Facility | | $4,268.64 | $5,175.39 | $5,966.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,234.60 / $10,234.60 / $10,234.60
| Facility | | $10,234.60 | $10,234.60 | $10,234.60 |
- 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
- $3,797.26 / $6,044.19 / $10,373.71
| Facility | | $3,797.26 | $6,044.19 | $10,373.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $8,984.45
| Facility | | $2,332.00 | $5,044.00 | $8,984.45 |