- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,931.00 / $19,879.40 / $27,500.90
| Facility | | $5,931.00 | $19,879.40 | $27,500.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,106.82
| Facility | | $1,146.00 | $3,000.00 | $9,106.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,482.35 / $10,338.33 / $19,176.11
| Facility | | $7,482.35 | $10,338.33 | $19,176.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,482.35 / $10,675.80 / $19,176.11
| Facility | | $7,482.35 | $10,675.80 | $19,176.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,232.06 / $20,516.52
| Facility | | $5,419.00 | $13,232.06 | $20,516.52 |