- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,355.00 / $17,948.80 / $24,830.10
| Facility | | $5,355.00 | $17,948.80 | $24,830.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $10,235.84
| Facility | | $1,146.00 | $3,000.00 | $10,235.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,755.69 / $9,334.29 / $17,313.79
| Facility | | $6,755.69 | $9,334.29 | $17,313.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,755.69 / $9,639.00 / $17,313.79
| Facility | | $6,755.69 | $9,639.00 | $17,313.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,033.70 / $11,947.01 / $18,524.02
| Facility | | $5,033.70 | $11,947.01 | $18,524.02 |