- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,003.00 / $13,417.20 / $18,561.09
| Facility | | $4,003.00 | $13,417.20 | $18,561.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $4,750.24
| Facility | | $1,146.00 | $3,000.00 | $4,750.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,050.05 / $6,977.63 / $12,942.50
| Facility | | $5,050.05 | $6,977.63 | $12,942.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,050.05 / $7,205.40 / $12,942.50
| Facility | | $5,050.05 | $7,205.40 | $12,942.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,762.82 / $8,930.69 / $13,847.18
| Facility | | $3,762.82 | $8,930.69 | $13,847.18 |