- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,509.50 / $11,763.10 / $16,272.80
| Facility | | $3,509.50 | $11,763.10 | $16,272.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,017.14
| Facility | | $1,146.00 | $3,000.00 | $5,017.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,427.47 / $6,117.41 / $11,346.92
| Facility | | $4,427.47 | $6,117.41 | $11,346.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,427.47 / $6,117.41 / $11,346.92
| Facility | | $4,427.47 | $6,117.41 | $11,346.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,298.93 / $7,829.69 / $12,140.06
| Facility | | $3,298.93 | $7,829.69 | $12,140.06 |