- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,788.76 / $11,588.20 / $18,835.59
| Facility | | $6,788.76 | $11,588.20 | $18,835.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.00 / $730.00 / $730.00
| Facility | | $730.00 | $730.00 | $730.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,856.35 / $9,207.36 / $14,525.50
| Facility | | $5,856.35 | $9,207.36 | $14,525.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,397.09 / $9,773.70 / $18,962.50
| Facility | | $5,397.09 | $9,773.70 | $18,962.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $9,880.12 / $13,242.81
| Facility | | $6,164.00 | $9,880.12 | $13,242.81 |