- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,204.50 / $20,796.09 / $28,769.00
| Facility | | $6,204.50 | $20,796.09 | $28,769.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,701.37
| Facility | | $1,146.00 | $3,000.00 | $6,701.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,827.39 / $10,815.06 / $20,060.39
| Facility | | $7,827.39 | $10,815.06 | $20,060.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,827.39 / $10,815.06 / $20,060.39
| Facility | | $7,827.39 | $10,815.06 | $20,060.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $14,028.37 / $21,462.61
| Facility | | $5,419.00 | $14,028.37 | $21,462.61 |