- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.50 / $13,345.10 / $18,461.40
| Facility | | $3,981.50 | $13,345.10 | $18,461.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,516.09
| Facility | | $1,146.00 | $3,000.00 | $5,516.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,022.93 / $6,940.15 / $12,872.99
| Facility | | $5,022.93 | $6,940.15 | $12,872.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,022.93 / $6,940.15 / $12,872.99
| Facility | | $5,022.93 | $6,940.15 | $12,872.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,742.61 / $8,882.73 / $13,772.80
| Facility | | $3,742.61 | $8,882.73 | $13,772.80 |