- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,136.50 / $13,864.70 / $19,180.09
| Facility | | $4,136.50 | $13,864.70 | $19,180.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,458.75 / $3,841.63
| Facility | | $1,146.00 | $2,458.75 | $3,841.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,218.47 / $7,210.33 / $13,374.13
| Facility | | $5,218.47 | $7,210.33 | $13,374.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,218.47 / $7,210.33 / $13,374.13
| Facility | | $5,218.47 | $7,210.33 | $13,374.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,888.31 / $9,228.53 / $14,308.98
| Facility | | $3,888.31 | $9,228.53 | $14,308.98 |