- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,964.00 / $30,045.40 / $41,564.30
| Facility | | $8,964.00 | $30,045.40 | $41,564.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,161.30
| Facility | | $1,146.00 | $3,000.00 | $5,161.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,308.68 / $15,625.15 / $28,982.40
| Facility | | $11,308.68 | $15,625.15 | $28,982.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,559.76 / $15,625.15 / $28,982.40
| Facility | | $10,559.76 | $15,625.15 | $28,982.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,998.68 / $31,008.27
| Facility | | $5,419.00 | $19,998.68 | $31,008.27 |