- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,951.50 / $13,244.60 / $18,322.30
| Facility | | $3,951.50 | $13,244.60 | $18,322.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $8,777.14
| Facility | | $1,146.00 | $3,000.00 | $8,777.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,985.08 / $6,887.86 / $12,775.99
| Facility | | $4,985.08 | $6,887.86 | $12,775.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,985.08 / $6,887.86 / $12,775.99
| Facility | | $4,985.08 | $6,887.86 | $12,775.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,714.41 / $8,815.79 / $13,669.03
| Facility | | $3,714.41 | $8,815.79 | $13,669.03 |