- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,648.50 / $15,580.80 / $21,554.20
| Facility | | $4,648.50 | $15,580.80 | $21,554.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,822.95
| Facility | | $1,146.00 | $3,000.00 | $7,822.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,864.39 / $8,102.80 / $15,029.53
| Facility | | $5,864.39 | $8,102.80 | $15,029.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,864.39 / $8,367.29 / $15,029.53
| Facility | | $5,864.39 | $8,367.29 | $15,029.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,369.59 / $10,510.26 / $21,321.74
| Facility | | $4,369.59 | $10,510.26 | $21,321.74 |