- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,648.50 / $12,229.00 / $16,917.40
| Facility | | $3,648.50 | $12,229.00 | $16,917.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,652.09
| Facility | | $1,146.00 | $3,000.00 | $6,652.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,602.82 / $6,359.70 / $11,796.33
| Facility | | $4,602.82 | $6,359.70 | $11,796.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,602.82 / $6,567.30 / $11,796.33
| Facility | | $4,602.82 | $6,567.30 | $11,796.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,429.59 / $8,139.80 / $12,620.89
| Facility | | $3,429.59 | $8,139.80 | $12,620.89 |