- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $22,611.10 / $31,279.90
| Facility | | $6,746.00 | $22,611.10 | $31,279.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,619.75
| Facility | | $1,146.00 | $3,000.00 | $7,619.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,510.52 / $11,758.95 / $21,811.17
| Facility | | $8,510.52 | $11,758.95 | $21,811.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,510.52 / $11,962.76 / $21,811.17
| Facility | | $8,510.52 | $11,962.76 | $21,811.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $15,050.33 / $23,335.76
| Facility | | $5,419.00 | $15,050.33 | $23,335.76 |