- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,813.50 / $26,189.20 / $36,229.60
| Facility | | $7,813.50 | $26,189.20 | $36,229.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $15,388.04
| Facility | | $1,146.00 | $3,000.00 | $15,388.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,857.25 / $13,619.71 / $25,262.61
| Facility | | $9,857.25 | $13,619.71 | $25,262.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,857.25 / $14,064.30 / $25,262.61
| Facility | | $9,857.25 | $14,064.30 | $25,262.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,431.91 / $27,028.46
| Facility | | $5,419.00 | $17,431.91 | $27,028.46 |