- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,036.00 / $20,231.40 / $27,987.70
| Facility | | $6,036.00 | $20,231.40 | $27,987.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,099.84
| Facility | | $1,146.00 | $3,000.00 | $9,099.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,614.81 / $10,521.35 / $19,515.59
| Facility | | $7,614.81 | $10,521.35 | $19,515.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,614.81 / $10,748.36 / $19,515.59
| Facility | | $7,614.81 | $10,748.36 | $19,515.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,466.32 / $20,879.73
| Facility | | $5,419.00 | $13,466.32 | $20,879.73 |