- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,755.86 / $6,978.53 / $8,045.84
| Facility | | $5,755.86 | $6,978.53 | $8,045.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,087.96 / $8,594.21 / $14,183.32
| Facility | | $7,087.96 | $8,594.21 | $14,183.32 |
- 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
- $5,007.24 / $5,561.64 / $13,987.97
| Facility | | $5,007.24 | $5,561.64 | $13,987.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $12,114.66
| Facility | | $2,332.00 | $5,044.00 | $12,114.66 |