- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,945.50 / $16,576.20 / $22,931.30
| Facility | | $4,945.50 | $16,576.20 | $22,931.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,695.55
| Facility | | $1,146.00 | $3,000.00 | $7,695.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,239.07 / $8,620.50 / $15,989.79
| Facility | | $6,239.07 | $8,620.50 | $15,989.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,239.07 / $8,901.90 / $15,989.79
| Facility | | $6,239.07 | $8,901.90 | $15,989.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,648.77 / $11,033.41 / $17,107.47
| Facility | | $4,648.77 | $11,033.41 | $17,107.47 |