- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,914.34 / $8,121.76 / $10,894.60
| Facility | | $3,914.34 | $8,121.76 | $10,894.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,455.27 / $10,306.18 / $17,229.93
| Facility | | $3,455.27 | $10,306.18 | $17,229.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.00 / $850.00 / $850.00
| Facility | | $850.00 | $850.00 | $850.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,903.50 / $10,183.98 / $11,432.26
| Facility | | $6,903.50 | $10,183.98 | $11,432.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,468.00 / $10,361.42
| Facility | | $1,350.00 | $5,468.00 | $10,361.42 |