- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,622.00 / $28,899.10 / $39,978.50
| Facility | | $8,622.00 | $28,899.10 | $39,978.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,269.39
| Facility | | $1,146.00 | $3,000.00 | $6,269.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,877.22 / $15,029.01 / $27,876.65
| Facility | | $10,877.22 | $15,029.01 | $27,876.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,272.64 / $15,029.01 / $27,876.65
| Facility | | $8,272.64 | $15,029.01 | $27,876.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,235.68 / $29,825.22
| Facility | | $5,419.00 | $19,235.68 | $29,825.22 |