- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,199.57 / $6,638.72 / $8,905.27
| Facility | | $3,199.57 | $6,638.72 | $8,905.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,982.49 / $14,982.49 / $15,570.96
| Facility | | $14,982.49 | $14,982.49 | $15,570.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $5,834.88 / $6,937.95
| Facility | | $2,651.00 | $5,834.88 | $6,937.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,642.91 / $6,855.20 / $10,789.88
| Facility | | $5,642.91 | $6,855.20 | $10,789.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,148.00 / $8,469.42
| Facility | | $1,000.00 | $5,148.00 | $8,469.42 |