- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,020.50 / $26,883.00 / $37,189.50
| Facility | | $8,020.50 | $26,883.00 | $37,189.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $17,356.84
| Facility | | $1,146.00 | $3,000.00 | $17,356.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,118.39 / $13,980.53 / $25,931.88
| Facility | | $10,118.39 | $13,980.53 | $25,931.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,118.39 / $13,980.53 / $25,110.63
| Facility | | $10,118.39 | $13,980.53 | $25,110.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,893.74 / $27,744.51
| Facility | | $5,419.00 | $17,893.74 | $27,744.51 |