- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,771.50 / $15,993.00 / $22,124.50
| Facility | | $4,771.50 | $15,993.00 | $22,124.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,259.88
| Facility | | $1,146.00 | $3,000.00 | $5,259.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,019.56 / $8,317.20 / $15,427.21
| Facility | | $6,019.56 | $8,317.20 | $15,427.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,019.56 / $8,317.20 / $15,427.21
| Facility | | $6,019.56 | $8,317.20 | $15,427.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,485.21 / $11,403.55 / $16,505.57
| Facility | | $4,485.21 | $11,403.55 | $16,505.57 |