- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,655.50 / $18,956.00 / $26,223.40
| Facility | | $5,655.50 | $18,956.00 | $26,223.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,828.07
| Facility | | $1,146.00 | $3,000.00 | $7,828.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,134.79 / $9,858.10 / $18,285.36
| Facility | | $7,134.79 | $9,858.10 | $18,285.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,134.79 / $10,179.90 / $18,285.36
| Facility | | $7,134.79 | $10,179.90 | $18,285.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,316.17 / $12,617.42 / $19,563.50
| Facility | | $5,316.17 | $12,617.42 | $19,563.50 |