- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,493.00 / $18,411.30 / $25,469.90
| Facility | | $5,493.00 | $18,411.30 | $25,469.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,479.82
| Facility | | $1,146.00 | $3,000.00 | $5,479.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,929.78 / $9,574.85 / $17,759.97
| Facility | | $6,929.78 | $9,574.85 | $17,759.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,929.78 / $9,574.85 / $17,759.97
| Facility | | $6,929.78 | $9,574.85 | $17,759.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,163.42 / $12,254.88 / $19,001.39
| Facility | | $5,163.42 | $12,254.88 | $19,001.39 |