- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,535.97 / $9,411.60 / $12,624.80
| Facility | | $4,535.97 | $9,411.60 | $12,624.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,293.24 / $10,057.64 / $12,849.36
| Facility | | $4,293.24 | $10,057.64 | $12,849.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $8,347.95 / $9,926.11
| Facility | | $2,651.00 | $8,347.95 | $9,926.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,999.86 / $9,718.50 / $15,296.62
| Facility | | $7,999.86 | $9,718.50 | $15,296.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $12,006.95
| Facility | | $1,350.00 | $5,713.00 | $12,006.95 |