- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,320.50 / $17,833.20 / $24,670.10
| Facility | | $5,320.50 | $17,833.20 | $24,670.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,437.26
| Facility | | $1,146.00 | $3,000.00 | $6,437.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,712.16 / $9,274.16 / $17,202.24
| Facility | | $6,712.16 | $9,274.16 | $17,202.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,712.16 / $9,357.32 / $17,202.24
| Facility | | $6,712.16 | $9,357.32 | $17,202.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,001.27 / $11,870.04 / $18,404.66
| Facility | | $5,001.27 | $11,870.04 | $18,404.66 |