- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,911.85 / $8,380.09 / $9,661.75
| Facility | | $6,911.85 | $8,380.09 | $9,661.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,455.78 / $9,455.78 / $9,455.78
| Facility | | $9,455.78 | $9,455.78 | $9,455.78 |
- 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
- $6,148.58 / $9,786.84 / $16,797.28
| Facility | | $6,148.58 | $9,786.84 | $16,797.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,156.00 / $6,585.00 / $12,673.50
| Facility | | $2,156.00 | $6,585.00 | $12,673.50 |