- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,908.50 / $13,100.40 / $18,122.90
| Facility | | $3,908.50 | $13,100.40 | $18,122.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,757.30 / $4,238.27
| Facility | | $1,146.00 | $2,757.30 | $4,238.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,930.83 / $6,812.91 / $12,636.96
| Facility | | $4,930.83 | $6,812.91 | $12,636.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,930.83 / $6,812.91 / $12,636.96
| Facility | | $4,930.83 | $6,812.91 | $12,636.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,673.99 / $9,697.17 / $13,520.28
| Facility | | $3,673.99 | $9,697.17 | $13,520.28 |