- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,874.30 / $10,113.60 / $13,566.50
| Facility | | $4,874.30 | $10,113.60 | $13,566.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,072.24 / $11,971.82 / $22,198.79
| Facility | | $5,072.24 | $11,971.82 | $22,198.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $8,590.20 / $10,214.15
| Facility | | $2,651.00 | $8,590.20 | $10,214.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,596.53 / $10,443.35 / $16,437.50
| Facility | | $8,596.53 | $10,443.35 | $16,437.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $12,902.48
| Facility | | $1,350.00 | $5,713.00 | $12,902.48 |