- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,698.00 / $16,755.50 / $138,142.00
| Facility | | $5,698.00 | $16,755.50 | $138,142.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,139.50 / $14,124.67 / $15,179.85
| Facility | | $9,139.50 | $14,124.67 | $15,179.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,779.85 / $12,862.79 / $23,390.45
| Facility | | $5,779.85 | $12,862.79 | $23,390.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,457.02 / $18,448.31 / $28,992.81
| Facility | | $10,457.02 | $18,448.31 | $28,992.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $21,251.46 / $32,320.83
| Facility | | $6,965.00 | $21,251.46 | $32,320.83 |