- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,886.47 / $5,362.71 / $8,975.28
| Facility | | $3,886.47 | $5,362.71 | $8,975.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,836.16 / $8,836.16 / $13,115.59
| Facility | | $8,836.16 | $8,836.16 | $13,115.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $5,970.76 / $9,477.58
| Facility | | $2,423.00 | $5,970.76 | $9,477.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,886.47 / $3,886.47 / $3,886.47
| Facility | | $3,886.47 | $3,886.47 | $3,886.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $4,869.18 / $10,827.21
| Facility | | $2,600.00 | $4,869.18 | $10,827.21 |