- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,076.50 / $17,015.30 / $23,538.70
| Facility | | $5,076.50 | $17,015.30 | $23,538.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,739.80 / $4,215.02
| Facility | | $1,146.00 | $2,739.80 | $4,215.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,404.34 / $8,848.85 / $16,413.34
| Facility | | $6,404.34 | $8,848.85 | $16,413.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,404.34 / $9,137.70 / $16,413.34
| Facility | | $6,404.34 | $9,137.70 | $16,413.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,771.91 / $11,325.67 / $17,560.63
| Facility | | $4,771.91 | $11,325.67 | $17,560.63 |