- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,354.50 / $14,595.30 / $20,190.90
| Facility | | $4,354.50 | $14,595.30 | $20,190.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $4,582.84
| Facility | | $1,146.00 | $3,000.00 | $4,582.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,493.49 / $7,590.33 / $14,078.97
| Facility | | $5,493.49 | $7,590.33 | $14,078.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,493.49 / $7,720.64 / $14,078.97
| Facility | | $5,493.49 | $7,720.64 | $14,078.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,093.23 / $9,714.89 / $15,063.09
| Facility | | $4,093.23 | $9,714.89 | $15,063.09 |