- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,177.00 / $20,704.00 / $28,641.50
| Facility | | $6,177.00 | $20,704.00 | $28,641.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,875.46
| Facility | | $1,146.00 | $3,000.00 | $9,875.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,792.69 / $10,767.13 / $19,971.48
| Facility | | $7,792.69 | $10,767.13 | $19,971.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,792.69 / $11,118.60 / $19,971.48
| Facility | | $7,792.69 | $11,118.60 | $19,971.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,780.89 / $21,367.48
| Facility | | $5,419.00 | $13,780.89 | $21,367.48 |