- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,498.50 / $11,726.20 / $16,221.80
| Facility | | $3,498.50 | $11,726.20 | $16,221.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,408.21
| Facility | | $1,146.00 | $3,000.00 | $5,408.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,413.59 / $6,098.24 / $11,311.35
| Facility | | $4,413.59 | $6,098.24 | $11,311.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,413.59 / $6,098.24 / $11,311.35
| Facility | | $4,413.59 | $6,098.24 | $11,311.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,288.59 / $7,805.15 / $12,102.01
| Facility | | $3,288.59 | $7,805.15 | $12,102.01 |