- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,455.50 / $35,044.60 / $48,480.10
| Facility | | $10,455.50 | $35,044.60 | $48,480.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $13,141.16
| Facility | | $1,146.00 | $3,000.00 | $13,141.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,190.30 / $18,224.98 / $33,804.72
| Facility | | $13,190.30 | $18,224.98 | $33,804.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,190.30 / $18,819.90 / $33,804.72
| Facility | | $13,190.30 | $18,819.90 | $33,804.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $23,326.22 / $36,167.67
| Facility | | $5,419.00 | $23,326.22 | $36,167.67 |