- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,215.50 / $24,184.80 / $33,456.80
| Facility | | $7,215.50 | $24,184.80 | $33,456.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,593.28
| Facility | | $1,146.00 | $3,000.00 | $5,593.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,102.83 / $12,577.34 / $23,329.15
| Facility | | $9,102.83 | $12,577.34 | $23,329.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,102.83 / $12,577.34 / $23,329.15
| Facility | | $9,102.83 | $12,577.34 | $23,329.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $16,097.78 / $24,959.86
| Facility | | $5,419.00 | $16,097.78 | $24,959.86 |