- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,580.00 / $15,351.20 / $21,236.50
| Facility | | $4,580.00 | $15,351.20 | $21,236.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $1,900.50 / $3,099.95
| Facility | | $1,146.00 | $1,900.50 | $3,099.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,777.97 / $7,983.40 / $14,808.06
| Facility | | $5,777.97 | $7,983.40 | $14,808.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,777.97 / $7,983.40 / $14,808.06
| Facility | | $5,777.97 | $7,983.40 | $14,808.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,305.20 / $10,217.98 / $15,843.14
| Facility | | $4,305.20 | $10,217.98 | $15,843.14 |