- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,206.50 / $14,099.30 / $19,504.70
| Facility | | $4,206.50 | $14,099.30 | $19,504.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $1,720.95 / $3,000.00
| Facility | | $1,146.00 | $1,720.95 | $3,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,306.78 / $7,332.35 / $13,600.46
| Facility | | $5,306.78 | $7,332.35 | $13,600.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,565.04 / $7,332.35 / $13,600.46
| Facility | | $4,565.04 | $7,332.35 | $13,600.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,954.11 / $9,384.70 / $14,551.12
| Facility | | $3,954.11 | $9,384.70 | $14,551.12 |