- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,286.75 / $6,344.22 / $8,869.10
| Facility | | $4,286.75 | $6,344.22 | $8,869.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,410.73 / $7,758.00 / $8,960.00
| Facility | | $6,410.73 | $7,758.00 | $8,960.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,671.58 / $8,063.00 / $10,337.18
| Facility | | $5,671.58 | $8,063.00 | $10,337.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,596.92 / $5,979.79 / $594,737.48
| Facility | | $2,596.92 | $5,979.79 | $594,737.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,286.75 / $6,396.00 / $9,721.95
| Facility | | $4,286.75 | $6,396.00 | $9,721.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.00 / $6,420.41 / $10,148.73
| Facility | | $3,800.00 | $6,420.41 | $10,148.73 |