- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,911.50 / $26,517.60 / $36,684.00
| Facility | | $7,911.50 | $26,517.60 | $36,684.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $8,783.65
| Facility | | $1,146.00 | $3,000.00 | $8,783.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,980.87 / $13,790.54 / $25,579.46
| Facility | | $9,980.87 | $13,790.54 | $25,579.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,980.87 / $14,240.70 / $25,579.46
| Facility | | $9,980.87 | $14,240.70 | $25,579.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,650.56 / $27,367.46
| Facility | | $5,419.00 | $17,650.56 | $27,367.46 |