- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,996.50 / $26,802.50 / $37,078.19
| Facility | | $7,996.50 | $26,802.50 | $37,078.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,730.21
| Facility | | $1,146.00 | $3,000.00 | $6,730.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,088.11 / $13,938.70 / $25,854.28
| Facility | | $10,088.11 | $13,938.70 | $25,854.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,088.11 / $14,393.70 / $25,854.28
| Facility | | $10,088.11 | $14,393.70 | $25,854.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,840.18 / $27,661.49
| Facility | | $5,419.00 | $17,840.18 | $27,661.49 |