- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,163.50 / $27,362.30 / $37,852.50
| Facility | | $8,163.50 | $27,362.30 | $37,852.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $10,244.20
| Facility | | $1,146.00 | $3,000.00 | $10,244.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,298.79 / $14,229.80 / $26,394.23
| Facility | | $10,298.79 | $14,229.80 | $26,394.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,298.79 / $14,229.80 / $26,394.23
| Facility | | $10,298.79 | $14,229.80 | $26,394.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $18,212.77 / $28,239.18
| Facility | | $5,419.00 | $18,212.77 | $28,239.18 |