- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.50 / $12,654.70 / $17,506.20
| Facility | | $3,775.50 | $12,654.70 | $17,506.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $4,725.13
| Facility | | $1,146.00 | $3,000.00 | $4,725.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,763.04 / $6,581.07 / $12,206.95
| Facility | | $4,763.04 | $6,581.07 | $12,206.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,763.04 / $6,581.07 / $12,206.95
| Facility | | $4,763.04 | $6,581.07 | $12,206.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.97 / $8,423.14 / $13,060.21
| Facility | | $3,548.97 | $8,423.14 | $13,060.21 |