- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,041.50 / $20,249.80 / $28,013.20
| Facility | | $6,041.50 | $20,249.80 | $28,013.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,211.94
| Facility | | $1,146.00 | $3,000.00 | $7,211.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,621.75 / $10,530.94 / $19,533.38
| Facility | | $7,621.75 | $10,530.94 | $19,533.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,621.75 / $10,530.94 / $19,533.38
| Facility | | $7,621.75 | $10,530.94 | $19,533.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $14,231.46 / $20,898.75
| Facility | | $5,419.00 | $14,231.46 | $20,898.75 |