- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,820.50 / $29,564.40 / $40,898.90
| Facility | | $8,820.50 | $29,564.40 | $40,898.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $12,582.23
| Facility | | $1,146.00 | $3,000.00 | $12,582.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,127.64 / $15,375.01 / $28,518.44
| Facility | | $11,127.64 | $15,375.01 | $28,518.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,127.64 / $15,876.90 / $28,518.44
| Facility | | $11,127.64 | $15,876.90 | $28,518.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,678.54 / $30,511.87
| Facility | | $5,419.00 | $19,678.54 | $30,511.87 |