- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,489.50 / $28,455.00 / $39,364.10
| Facility | | $8,489.50 | $28,455.00 | $39,364.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $11,271.86
| Facility | | $1,146.00 | $3,000.00 | $11,271.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,710.06 / $14,798.05 / $27,448.25
| Facility | | $10,710.06 | $14,798.05 | $27,448.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,710.06 / $14,798.05 / $27,448.25
| Facility | | $10,710.06 | $14,798.05 | $27,448.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $18,940.07 / $29,366.88
| Facility | | $5,419.00 | $18,940.07 | $29,366.88 |