- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,406.50 / $11,417.90 / $15,795.30
| Facility | | $3,406.50 | $11,417.90 | $15,795.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,200.35
| Facility | | $1,146.00 | $3,000.00 | $5,200.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,297.52 / $5,937.87 / $11,013.90
| Facility | | $4,297.52 | $5,937.87 | $11,013.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,297.52 / $6,131.70 / $11,013.90
| Facility | | $4,297.52 | $6,131.70 | $11,013.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,202.11 / $7,599.90 / $11,783.76
| Facility | | $3,202.11 | $7,599.90 | $11,783.76 |