- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,208.00 / $17,456.09 / $24,148.50
| Facility | | $5,208.00 | $17,456.09 | $24,148.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,477.96
| Facility | | $1,146.00 | $3,000.00 | $5,477.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,570.24 / $9,078.06 / $16,838.50
| Facility | | $6,570.24 | $9,078.06 | $16,838.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,570.24 / $9,170.56 / $16,838.50
| Facility | | $6,570.24 | $9,170.56 | $16,838.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,895.52 / $11,619.05 / $18,015.50
| Facility | | $4,895.52 | $11,619.05 | $18,015.50 |