- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,806.50 / $16,110.30 / $22,286.80
| Facility | | $4,806.50 | $16,110.30 | $22,286.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,593.50 / $4,020.65
| Facility | | $1,146.00 | $2,593.50 | $4,020.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,063.72 / $8,378.20 / $15,540.38
| Facility | | $6,063.72 | $8,378.20 | $15,540.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,063.72 / $8,378.20 / $15,540.38
| Facility | | $6,063.72 | $8,378.20 | $15,540.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,518.10 / $10,723.30 / $16,626.64
| Facility | | $4,518.10 | $10,723.30 | $16,626.64 |