- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,903.50 / $23,139.00 / $32,010.10
| Facility | | $6,903.50 | $23,139.00 | $32,010.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,360.06
| Facility | | $1,146.00 | $3,000.00 | $6,360.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.21 / $12,033.49 / $22,320.40
| Facility | | $8,709.21 | $12,033.49 | $22,320.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.21 / $12,313.28 / $22,320.40
| Facility | | $8,709.21 | $12,313.28 | $22,320.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $15,401.71 / $23,880.59
| Facility | | $5,419.00 | $15,401.71 | $23,880.59 |