- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,566.00 / $15,304.20 / $21,171.60
| Facility | | $4,566.00 | $15,304.20 | $21,171.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $23,932.88
| Facility | | $1,146.00 | $3,000.00 | $23,932.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,760.31 / $7,958.99 / $14,762.79
| Facility | | $5,760.31 | $7,958.99 | $14,762.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,760.31 / $7,958.99 / $14,762.79
| Facility | | $5,760.31 | $7,958.99 | $14,762.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,292.04 / $10,186.75 / $15,794.71
| Facility | | $4,292.04 | $10,186.75 | $15,794.71 |