- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,745.50 / $15,905.90 / $22,003.90
| Facility | | $4,745.50 | $15,905.90 | $22,003.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $8,612.06
| Facility | | $1,146.00 | $3,000.00 | $8,612.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,986.76 / $8,271.87 / $15,343.15
| Facility | | $5,986.76 | $8,271.87 | $15,343.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,986.76 / $8,541.90 / $15,343.15
| Facility | | $5,986.76 | $8,541.90 | $15,343.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,460.77 / $10,587.21 / $16,415.63
| Facility | | $4,460.77 | $10,587.21 | $16,415.63 |