- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,219.26 / $6,327.95 / $7,295.76
| Facility | | $5,219.26 | $6,327.95 | $7,295.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,037.14 / $7,193.43 / $10,534.24
| Facility | | $5,037.14 | $7,193.43 | $10,534.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $2,554.00 / $3,843.00
| Facility | | $1,252.00 | $2,554.00 | $3,843.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,642.89 / $7,390.22 / $12,683.92
| Facility | | $4,642.89 | $7,390.22 | $12,683.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,044.00 / $10,985.26
| Facility | | $2,332.00 | $5,044.00 | $10,985.26 |