- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,134.67 / $7,437.81 / $8,575.36
| Facility | | $6,134.67 | $7,437.81 | $8,575.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,989.77 / $9,059.01 / $12,186.41
| Facility | | $8,989.77 | $9,059.01 | $12,186.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $800.00 / $850.00 / $1,246.00
| Facility | | $800.00 | $850.00 | $1,246.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,336.78 / $5,927.67 / $14,908.56
| Facility | | $5,336.78 | $5,927.67 | $14,908.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $12,911.97
| Facility | | $2,332.00 | $5,044.00 | $12,911.97 |