- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,048.00 / $20,271.59 / $28,043.40
| Facility | | $6,048.00 | $20,271.59 | $28,043.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,320.71
| Facility | | $1,146.00 | $3,000.00 | $9,320.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,629.95 / $10,542.27 / $19,554.39
| Facility | | $7,629.95 | $10,542.27 | $19,554.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,629.95 / $10,886.40 / $19,554.39
| Facility | | $7,629.95 | $10,886.40 | $19,554.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,493.09 / $20,921.24
| Facility | | $5,419.00 | $13,493.09 | $20,921.24 |