- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,436.00 / $31,627.40 / $43,752.80
| Facility | | $9,436.00 | $31,627.40 | $43,752.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $11,397.41
| Facility | | $1,146.00 | $3,000.00 | $11,397.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,904.14 / $16,447.89 / $30,508.48
| Facility | | $11,904.14 | $16,447.89 | $30,508.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,904.14 / $16,447.89 / $30,508.48
| Facility | | $11,904.14 | $16,447.89 | $30,508.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $21,051.72 / $32,641.01
| Facility | | $5,419.00 | $21,051.72 | $32,641.01 |