- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,334.00 / $14,526.60 / $20,095.90
| Facility | | $4,334.00 | $14,526.60 | $20,095.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,239.65 / $3,550.54
| Facility | | $1,146.00 | $2,239.65 | $3,550.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,467.63 / $7,554.60 / $14,012.69
| Facility | | $5,467.63 | $7,554.60 | $14,012.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,467.63 / $7,554.60 / $14,012.69
| Facility | | $5,467.63 | $7,554.60 | $14,012.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.96 / $9,669.15 / $14,992.17
| Facility | | $4,073.96 | $9,669.15 | $14,992.17 |