- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,281.00 / $17,700.80 / $24,486.90
| Facility | | $5,281.00 | $17,700.80 | $24,486.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,796.24
| Facility | | $1,146.00 | $3,000.00 | $6,796.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,662.33 / $9,205.31 / $17,074.53
| Facility | | $6,662.33 | $9,205.31 | $17,074.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,662.33 / $9,205.31 / $17,074.53
| Facility | | $6,662.33 | $9,205.31 | $17,074.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,964.14 / $11,781.91 / $18,268.04
| Facility | | $4,964.14 | $11,781.91 | $18,268.04 |