- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,959.50 / $26,678.50 / $36,906.60
| Facility | | $7,959.50 | $26,678.50 | $36,906.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,902.47
| Facility | | $1,146.00 | $3,000.00 | $7,902.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,041.43 / $13,874.20 / $25,734.66
| Facility | | $10,041.43 | $13,874.20 | $25,734.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,041.43 / $14,327.10 / $25,734.66
| Facility | | $10,041.43 | $14,327.10 | $25,734.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,757.64 / $27,533.50
| Facility | | $5,419.00 | $17,757.64 | $27,533.50 |