- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,844.50 / $29,644.90 / $41,010.19
| Facility | | $8,844.50 | $29,644.90 | $41,010.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $10,472.06
| Facility | | $1,146.00 | $3,000.00 | $10,472.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,157.92 / $15,416.85 / $28,596.04
| Facility | | $11,157.92 | $15,416.85 | $28,596.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,157.92 / $15,515.80 / $28,596.04
| Facility | | $11,157.92 | $15,515.80 | $28,596.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,732.08 / $30,594.89
| Facility | | $5,419.00 | $19,732.08 | $30,594.89 |