- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,544.00 / $21,934.10 / $30,343.20
| Facility | | $6,544.00 | $21,934.10 | $30,343.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,604.41
| Facility | | $1,146.00 | $3,000.00 | $7,604.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,255.69 / $11,406.85 / $21,158.06
| Facility | | $8,255.69 | $11,406.85 | $21,158.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,255.69 / $11,779.20 / $21,158.06
| Facility | | $8,255.69 | $11,779.20 | $21,158.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $14,599.66 / $22,637.00
| Facility | | $5,419.00 | $14,599.66 | $22,637.00 |