- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,916.08 / $5,960.37 / $6,871.96
| Facility | | $4,916.08 | $5,960.37 | $6,871.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,491.85 / $7,494.00 / $14,641.46
| Facility | | $7,491.85 | $7,494.00 | $14,641.46 |
- 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
- $4,373.20 / $6,960.93 / $11,947.13
| Facility | | $4,373.20 | $6,960.93 | $11,947.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,460.00 / $3,800.00 / $7,786.00
| Facility | | $1,460.00 | $3,800.00 | $7,786.00 |