- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,584.00 / $28,771.70 / $39,802.30
| Facility | | $8,584.00 | $28,771.70 | $39,802.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,321.72
| Facility | | $1,146.00 | $3,000.00 | $5,321.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,829.28 / $14,962.77 / $27,753.79
| Facility | | $10,829.28 | $14,962.77 | $27,753.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,829.28 / $14,962.77 / $27,753.79
| Facility | | $10,829.28 | $14,962.77 | $27,753.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,150.90 / $29,693.77
| Facility | | $5,419.00 | $19,150.90 | $29,693.77 |