- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,183.50 / $30,781.10 / $42,582.10
| Facility | | $9,183.50 | $30,781.10 | $42,582.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $10,400.92
| Facility | | $1,146.00 | $3,000.00 | $10,400.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,585.59 / $16,007.76 / $29,692.09
| Facility | | $11,585.59 | $16,007.76 | $29,692.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,585.59 / $16,390.72 / $29,692.09
| Facility | | $11,585.59 | $16,390.72 | $29,692.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $20,488.39 / $31,767.56
| Facility | | $5,419.00 | $20,488.39 | $31,767.56 |