- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,546.08 / $6,272.87 / $10,498.60
| Facility | | $4,546.08 | $6,272.87 | $10,498.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,745.53 / $14,745.53 / $14,745.53
| Facility | | $14,745.53 | $14,745.53 | $14,745.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,790.00 / $3,447.00 / $6,721.96
| Facility | | $1,790.00 | $3,447.00 | $6,721.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,652.88 / $7,057.25 / $11,834.96
| Facility | | $4,652.88 | $7,057.25 | $11,834.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,101.00 / $5,670.33 / $12,664.80
| Facility | | $2,101.00 | $5,670.33 | $12,664.80 |