- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.00 / $14,969.10 / $20,707.90
| Facility | | $4,466.00 | $14,969.10 | $20,707.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,858.45 / $4,372.64
| Facility | | $1,146.00 | $2,858.45 | $4,372.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,634.15 / $7,784.68 / $14,439.47
| Facility | | $5,634.15 | $7,784.68 | $14,439.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,634.15 / $7,906.48 / $14,439.47
| Facility | | $5,634.15 | $7,906.48 | $14,439.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,198.04 / $9,963.65 / $15,448.79
| Facility | | $4,198.04 | $9,963.65 | $15,448.79 |