- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,481.50 / $21,724.60 / $30,053.40
| Facility | | $6,481.50 | $21,724.60 | $30,053.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,756.42
| Facility | | $1,146.00 | $3,000.00 | $9,756.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,176.84 / $11,297.90 / $20,955.99
| Facility | | $8,176.84 | $11,297.90 | $20,955.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,176.84 / $11,666.70 / $20,955.99
| Facility | | $8,176.84 | $11,666.70 | $20,955.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $14,460.23 / $22,420.80
| Facility | | $5,419.00 | $14,460.23 | $22,420.80 |