- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,832.50 / $29,604.60 / $40,954.50
| Facility | | $8,832.50 | $29,604.60 | $40,954.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $13,494.56
| Facility | | $1,146.00 | $3,000.00 | $13,494.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,142.78 / $15,395.93 / $28,557.24
| Facility | | $11,142.78 | $15,395.93 | $28,557.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,142.78 / $15,898.50 / $28,557.24
| Facility | | $11,142.78 | $15,898.50 | $28,557.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,705.31 / $30,553.38
| Facility | | $5,419.00 | $19,705.31 | $30,553.38 |