- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,973.00 / $6,844.51 / $12,506.40
| Facility | | $1,973.00 | $6,844.51 | $12,506.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,238.75 / $7,721.45 / $8,776.25
| Facility | | $7,238.75 | $7,721.45 | $8,776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,441.87 / $6,650.14 / $11,247.82
| Facility | | $2,441.87 | $6,650.14 | $11,247.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,289.29 / $11,800.68 / $18,756.84
| Facility | | $7,289.29 | $11,800.68 | $18,756.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,609.45 / $11,204.14 / $16,358.95
| Facility | | $8,609.45 | $11,204.14 | $16,358.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,609.45 / $10,415.74 / $16,358.95
| Facility | | $8,609.45 | $10,415.74 | $16,358.95 |