- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,542.50 / $11,873.70 / $16,425.90
| Facility | | $3,542.50 | $11,873.70 | $16,425.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,100.00 / $3,365.00
| Facility | | $1,146.00 | $2,100.00 | $3,365.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,469.10 / $6,174.93 / $11,453.61
| Facility | | $4,469.10 | $6,174.93 | $11,453.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,469.10 / $6,174.93 / $11,453.61
| Facility | | $4,469.10 | $6,174.93 | $11,453.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,329.95 / $7,903.32 / $12,254.22
| Facility | | $3,329.95 | $7,903.32 | $12,254.22 |