- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,298.50 / $14,407.60 / $19,931.30
| Facility | | $4,298.50 | $14,407.60 | $19,931.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,747.20
| Facility | | $1,146.00 | $3,000.00 | $5,747.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,422.84 / $7,492.72 / $13,897.91
| Facility | | $5,422.84 | $7,492.72 | $13,897.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,422.84 / $7,737.30 / $13,897.91
| Facility | | $5,422.84 | $7,737.30 | $13,897.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,040.59 / $9,589.95 / $14,869.37
| Facility | | $4,040.59 | $9,589.95 | $14,869.37 |