- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,438.50 / $14,876.90 / $20,580.40
| Facility | | $4,438.50 | $14,876.90 | $20,580.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,995.04
| Facility | | $1,146.00 | $3,000.00 | $5,995.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,599.46 / $7,736.75 / $14,350.56
| Facility | | $5,599.46 | $7,736.75 | $14,350.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,599.46 / $7,767.56 / $14,350.56
| Facility | | $5,599.46 | $7,767.56 | $14,350.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,172.18 / $9,902.29 / $15,353.66
| Facility | | $4,172.18 | $9,902.29 | $15,353.66 |