- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,664.50 / $29,041.50 / $40,175.60
| Facility | | $8,664.50 | $29,041.50 | $40,175.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,001.09
| Facility | | $1,146.00 | $3,000.00 | $6,001.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,930.84 / $15,103.09 / $28,014.06
| Facility | | $10,930.84 | $15,103.09 | $28,014.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,930.84 / $15,103.09 / $28,014.06
| Facility | | $10,930.84 | $15,103.09 | $28,014.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,330.50 / $29,972.24
| Facility | | $5,419.00 | $19,330.50 | $29,972.24 |