- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,615.50 / $38,932.60 / $53,858.80
| Facility | | $11,615.50 | $38,932.60 | $53,858.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,286.35
| Facility | | $1,146.00 | $3,000.00 | $7,286.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,653.72 / $20,246.98 / $37,555.23
| Facility | | $14,653.72 | $20,246.98 | $37,555.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,653.72 / $20,246.98 / $37,555.23
| Facility | | $14,653.72 | $20,246.98 | $37,555.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $25,914.18 / $40,180.33
| Facility | | $5,419.00 | $25,914.18 | $40,180.33 |