- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,051.50 / $16,931.50 / $23,422.80
| Facility | | $5,051.50 | $16,931.50 | $23,422.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,610.87
| Facility | | $1,146.00 | $3,000.00 | $9,610.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,372.80 / $8,805.27 / $16,332.51
| Facility | | $6,372.80 | $8,805.27 | $16,332.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,372.80 / $9,092.70 / $16,332.51
| Facility | | $6,372.80 | $9,092.70 | $16,332.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,748.41 / $11,269.90 / $17,474.15
| Facility | | $4,748.41 | $11,269.90 | $17,474.15 |