- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,045.20 / $5,860.82 / $9,642.41
| Facility | | $4,045.20 | $5,860.82 | $9,642.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,961.43 / $8,962.37 / $9,861.59
| Facility | | $5,961.43 | $8,962.37 | $9,861.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,790.00 / $3,447.00 / $5,731.61
| Facility | | $1,790.00 | $3,447.00 | $5,731.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,347.24 / $6,593.68 / $11,057.55
| Facility | | $4,347.24 | $6,593.68 | $11,057.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.00 / $4,350.00 / $10,195.25
| Facility | | $1,778.00 | $4,350.00 | $10,195.25 |