- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,702.50 / $15,761.80 / $21,804.60
| Facility | | $4,702.50 | $15,761.80 | $21,804.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $12,405.99
| Facility | | $1,146.00 | $3,000.00 | $12,405.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,932.51 / $8,196.93 / $15,204.12
| Facility | | $5,932.51 | $8,196.93 | $15,204.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,932.51 / $8,464.50 / $15,204.12
| Facility | | $5,932.51 | $8,464.50 | $15,204.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,420.35 / $10,491.28 / $16,266.89
| Facility | | $4,420.35 | $10,491.28 | $16,266.89 |