- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,357.50 / $21,309.00 / $29,478.50
| Facility | | $6,357.50 | $21,309.00 | $29,478.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,825.25
| Facility | | $1,146.00 | $3,000.00 | $9,825.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,020.41 / $11,081.76 / $20,555.07
| Facility | | $8,020.41 | $11,081.76 | $20,555.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,020.41 / $11,443.50 / $20,555.07
| Facility | | $8,020.41 | $11,443.50 | $20,555.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $14,183.58 / $21,991.86
| Facility | | $5,419.00 | $14,183.58 | $21,991.86 |