- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,245.00 / $10,876.50 / $15,046.40
| Facility | | $3,245.00 | $10,876.50 | $15,046.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,988.30 / $4,545.17
| Facility | | $1,146.00 | $2,988.30 | $4,545.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,093.78 / $5,656.36 / $10,491.73
| Facility | | $4,093.78 | $5,656.36 | $10,491.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,093.78 / $5,841.00 / $10,491.73
| Facility | | $4,093.78 | $5,841.00 | $10,491.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,050.30 / $7,239.60 / $11,225.10
| Facility | | $3,050.30 | $7,239.60 | $11,225.10 |