- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,354.50 / $28,002.50 / $38,738.10
| Facility | | $8,354.50 | $28,002.50 | $38,738.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,217.31
| Facility | | $1,146.00 | $3,000.00 | $6,217.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,539.75 / $14,562.73 / $27,011.77
| Facility | | $10,539.75 | $14,562.73 | $27,011.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,539.75 / $14,755.88 / $27,011.77
| Facility | | $10,539.75 | $14,755.88 | $27,011.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $18,638.89 / $28,899.89
| Facility | | $5,419.00 | $18,638.89 | $28,899.89 |