- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,982.00 / $26,753.90 / $37,010.90
| Facility | | $7,982.00 | $26,753.90 | $37,010.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,805.75
| Facility | | $1,146.00 | $3,000.00 | $7,805.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,069.82 / $13,913.42 / $25,807.40
| Facility | | $10,069.82 | $13,913.42 | $25,807.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,069.82 / $13,913.42 / $25,807.40
| Facility | | $10,069.82 | $13,913.42 | $25,807.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,807.84 / $27,611.33
| Facility | | $5,419.00 | $17,807.84 | $27,611.33 |