- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,609.00 / $22,151.90 / $30,644.60
| Facility | | $6,609.00 | $22,151.90 | $30,644.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,331.48
| Facility | | $1,146.00 | $3,000.00 | $5,331.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,337.69 / $11,520.15 / $21,368.22
| Facility | | $8,337.69 | $11,520.15 | $21,368.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,337.69 / $11,520.15 / $21,368.22
| Facility | | $8,337.69 | $11,520.15 | $21,368.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $14,744.68 / $22,861.85
| Facility | | $5,419.00 | $14,744.68 | $22,861.85 |