- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,848.50 / $33,010.00 / $45,665.50
| Facility | | $9,848.50 | $33,010.00 | $45,665.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $12,774.74
| Facility | | $1,146.00 | $3,000.00 | $12,774.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,424.53 / $17,166.91 / $31,842.17
| Facility | | $12,424.53 | $17,166.91 | $31,842.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,424.53 / $17,727.30 / $31,842.17
| Facility | | $12,424.53 | $17,727.30 | $31,842.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $21,972.00 / $34,067.93
| Facility | | $5,419.00 | $21,972.00 | $34,067.93 |