- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,478.00 / $21,712.90 / $30,037.20
| Facility | | $6,478.00 | $21,712.90 | $30,037.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,352.41
| Facility | | $1,146.00 | $3,000.00 | $5,352.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,172.42 / $11,291.80 / $20,944.66
| Facility | | $8,172.42 | $11,291.80 | $20,944.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,172.42 / $11,291.80 / $20,944.66
| Facility | | $8,172.42 | $11,291.80 | $20,944.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $14,452.42 / $22,408.70
| Facility | | $5,419.00 | $14,452.42 | $22,408.70 |