- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,461.00 / $18,304.09 / $25,321.60
| Facility | | $5,461.00 | $18,304.09 | $25,321.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,889.91
| Facility | | $1,146.00 | $3,000.00 | $7,889.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,889.41 / $9,519.07 / $17,656.50
| Facility | | $6,889.41 | $9,519.07 | $17,656.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,889.41 / $9,519.07 / $17,656.50
| Facility | | $6,889.41 | $9,519.07 | $17,656.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,133.34 / $12,864.02 / $18,890.68
| Facility | | $5,133.34 | $12,864.02 | $18,890.68 |