- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,417.50 / $18,158.30 / $25,119.90
| Facility | | $5,417.50 | $18,158.30 | $25,119.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,383.78
| Facility | | $1,146.00 | $3,000.00 | $6,383.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,834.53 / $9,443.24 / $17,515.86
| Facility | | $6,834.53 | $9,443.24 | $17,515.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,834.53 / $9,751.50 / $17,515.86
| Facility | | $6,834.53 | $9,751.50 | $17,515.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,092.45 / $12,086.44 / $18,740.22
| Facility | | $5,092.45 | $12,086.44 | $18,740.22 |