- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,983.00 / $20,053.70 / $27,742.00
| Facility | | $5,983.00 | $20,053.70 | $27,742.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,355.42
| Facility | | $1,146.00 | $3,000.00 | $6,355.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,547.95 / $10,428.96 / $19,344.24
| Facility | | $7,547.95 | $10,428.96 | $19,344.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,547.95 / $10,428.96 / $19,344.24
| Facility | | $7,547.95 | $10,428.96 | $19,344.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,348.07 / $20,696.39
| Facility | | $5,419.00 | $13,348.07 | $20,696.39 |