- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,718.00 / $25,869.10 / $35,786.80
| Facility | | $7,718.00 | $25,869.10 | $35,786.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,740.65
| Facility | | $1,146.00 | $3,000.00 | $7,740.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,736.77 / $13,453.25 / $24,953.84
| Facility | | $9,736.77 | $13,453.25 | $24,953.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,736.77 / $13,453.25 / $24,953.84
| Facility | | $9,736.77 | $13,453.25 | $24,953.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,218.86 / $26,698.11
| Facility | | $5,419.00 | $17,218.86 | $26,698.11 |