- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,649.50 / $25,639.50 / $35,469.19
| Facility | | $7,649.50 | $25,639.50 | $35,469.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,754.10
| Facility | | $1,146.00 | $3,000.00 | $9,754.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,650.35 / $13,333.84 / $24,732.36
| Facility | | $9,650.35 | $13,333.84 | $24,732.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,650.35 / $13,619.68 / $24,732.36
| Facility | | $9,650.35 | $13,619.68 | $24,732.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,066.03 / $26,461.15
| Facility | | $5,419.00 | $17,066.03 | $26,461.15 |