- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,299.50 / $14,411.00 / $19,935.90
| Facility | | $4,299.50 | $14,411.00 | $19,935.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $4,581.43
| Facility | | $1,146.00 | $3,000.00 | $4,581.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,424.10 / $7,494.46 / $13,901.14
| Facility | | $5,424.10 | $7,494.46 | $13,901.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,424.10 / $7,494.46 / $13,901.14
| Facility | | $5,424.10 | $7,494.46 | $13,901.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,041.53 / $9,592.18 / $14,872.83
| Facility | | $4,041.53 | $9,592.18 | $14,872.83 |