- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,412.50 / $18,141.50 / $25,096.70
| Facility | | $5,412.50 | $18,141.50 | $25,096.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,141.98
| Facility | | $1,146.00 | $3,000.00 | $6,141.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,828.23 / $9,434.53 / $17,499.70
| Facility | | $6,828.23 | $9,434.53 | $17,499.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,828.23 / $9,434.53 / $17,499.70
| Facility | | $6,828.23 | $9,434.53 | $17,499.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,087.75 / $12,075.29 / $18,722.91
| Facility | | $5,087.75 | $12,075.29 | $18,722.91 |