- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,705.50 / $15,771.80 / $21,818.50
| Facility | | $4,705.50 | $15,771.80 | $21,818.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,912.48
| Facility | | $1,146.00 | $3,000.00 | $6,912.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,936.30 / $8,202.16 / $15,213.82
| Facility | | $5,936.30 | $8,202.16 | $15,213.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,936.30 / $8,202.16 / $15,213.82
| Facility | | $5,936.30 | $8,202.16 | $15,213.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,423.17 / $10,497.97 / $16,277.27
| Facility | | $4,423.17 | $10,497.97 | $16,277.27 |