- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,902.94 / $6,023.24 / $8,079.65
| Facility | | $2,902.94 | $6,023.24 | $8,079.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,776.00 / $9,431.04 / $9,820.68
| Facility | | $2,776.00 | $9,431.04 | $9,820.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $4,734.16 / $5,629.14
| Facility | | $2,651.00 | $4,734.16 | $5,629.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,119.75 / $6,219.65 / $9,789.54
| Facility | | $5,119.75 | $6,219.65 | $9,789.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,372.00 / $7,684.21
| Facility | | $1,350.00 | $5,372.00 | $7,684.21 |