- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,337.50 / $17,890.09 / $24,748.90
| Facility | | $5,337.50 | $17,890.09 | $24,748.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,168.23
| Facility | | $1,146.00 | $3,000.00 | $7,168.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,733.61 / $9,303.79 / $17,257.21
| Facility | | $6,733.61 | $9,303.79 | $17,257.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,733.61 / $9,303.79 / $17,257.21
| Facility | | $6,733.61 | $9,303.79 | $17,257.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,017.25 / $11,907.96 / $18,463.48
| Facility | | $5,017.25 | $11,907.96 | $18,463.48 |