- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,477.50 / $15,007.60 / $20,761.30
| Facility | | $4,477.50 | $15,007.60 | $20,761.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,405.19 / $3,770.48
| Facility | | $1,146.00 | $2,405.19 | $3,770.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,648.66 / $7,804.73 / $14,476.65
| Facility | | $5,648.66 | $7,804.73 | $14,476.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,648.66 / $7,804.73 / $14,476.65
| Facility | | $5,648.66 | $7,804.73 | $14,476.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,208.85 / $9,989.29 / $15,488.57
| Facility | | $4,208.85 | $9,989.29 | $15,488.57 |