- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,725.00 / $22,540.70 / $31,182.50
| Facility | | $6,725.00 | $22,540.70 | $31,182.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,042.93
| Facility | | $1,146.00 | $3,000.00 | $6,042.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,484.03 / $11,722.35 / $21,743.27
| Facility | | $8,484.03 | $11,722.35 | $21,743.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,484.03 / $11,722.35 / $21,743.27
| Facility | | $8,484.03 | $11,722.35 | $21,743.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $16,977.03 / $23,263.12
| Facility | | $5,419.00 | $16,977.03 | $23,263.12 |