- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,871.50 / $26,383.60 / $36,498.60
| Facility | | $7,871.50 | $26,383.60 | $36,498.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,685.57
| Facility | | $1,146.00 | $3,000.00 | $6,685.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,930.42 / $13,720.81 / $25,450.13
| Facility | | $9,930.42 | $13,720.81 | $25,450.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,930.42 / $13,720.81 / $25,450.13
| Facility | | $9,930.42 | $13,720.81 | $25,450.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,561.32 / $27,229.09
| Facility | | $5,419.00 | $17,561.32 | $27,229.09 |