- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,335.50 / $27,938.80 / $38,650.00
| Facility | | $8,335.50 | $27,938.80 | $38,650.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,436.54
| Facility | | $1,146.00 | $3,000.00 | $7,436.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,515.78 / $14,529.61 / $26,950.34
| Facility | | $10,515.78 | $14,529.61 | $26,950.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,515.78 / $14,743.92 / $26,950.34
| Facility | | $10,515.78 | $14,743.92 | $26,950.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $18,596.50 / $28,834.16
| Facility | | $5,419.00 | $18,596.50 | $28,834.16 |