- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,598.50 / $12,061.40 / $16,685.50
| Facility | | $3,598.50 | $12,061.40 | $16,685.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $4,776.27
| Facility | | $1,146.00 | $3,000.00 | $4,776.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,539.75 / $6,272.55 / $11,634.67
| Facility | | $4,539.75 | $6,272.55 | $11,634.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,539.75 / $6,272.55 / $11,634.67
| Facility | | $4,539.75 | $6,272.55 | $11,634.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,382.59 / $8,028.25 / $12,447.93
| Facility | | $3,382.59 | $8,028.25 | $12,447.93 |