- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,547.50 / $28,649.40 / $39,633.00
| Facility | | $8,547.50 | $28,649.40 | $39,633.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,694.15
| Facility | | $1,146.00 | $3,000.00 | $7,694.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,783.24 / $14,899.15 / $27,635.78
| Facility | | $10,783.24 | $14,899.15 | $27,635.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,783.24 / $15,154.24 / $27,635.78
| Facility | | $10,783.24 | $15,154.24 | $27,635.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,069.47 / $29,567.51
| Facility | | $5,419.00 | $19,069.47 | $29,567.51 |