- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,786.00 / $29,448.80 / $40,738.90
| Facility | | $8,786.00 | $29,448.80 | $40,738.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $16,566.81
| Facility | | $1,146.00 | $3,000.00 | $16,566.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,084.12 / $15,314.88 / $28,406.90
| Facility | | $11,084.12 | $15,314.88 | $28,406.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,084.12 / $15,814.80 / $28,406.90
| Facility | | $11,084.12 | $15,814.80 | $28,406.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,601.57 / $30,392.53
| Facility | | $5,419.00 | $19,601.57 | $30,392.53 |