- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,573.50 / $15,329.40 / $21,206.40
| Facility | | $4,573.50 | $15,329.40 | $21,206.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,858.55
| Facility | | $1,146.00 | $3,000.00 | $6,858.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,769.77 / $7,972.07 / $14,787.04
| Facility | | $5,769.77 | $7,972.07 | $14,787.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,769.77 / $7,972.07 / $14,787.04
| Facility | | $5,769.77 | $7,972.07 | $14,787.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,299.09 / $10,203.48 / $15,820.65
| Facility | | $4,299.09 | $10,203.48 | $15,820.65 |