- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,380.50 / $28,089.60 / $38,858.69
| Facility | | $8,380.50 | $28,089.60 | $38,858.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,518.41
| Facility | | $1,146.00 | $3,000.00 | $5,518.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,572.55 / $14,608.05 / $27,095.83
| Facility | | $10,572.55 | $14,608.05 | $27,095.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,572.55 / $15,037.40 / $27,095.83
| Facility | | $10,572.55 | $15,037.40 | $27,095.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $18,696.90 / $28,989.83
| Facility | | $5,419.00 | $18,696.90 | $28,989.83 |