- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,558.80 / $26,656.81 / $34,970.69
| Facility | | $10,558.80 | $26,656.81 | $34,970.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $9,694.11
| Facility | | $1,146.00 | $3,000.00 | $9,694.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,514.73 / $13,146.46 / $24,384.79
| Facility | | $9,514.73 | $13,146.46 | $24,384.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,514.73 / $13,575.60 / $24,384.79
| Facility | | $9,514.73 | $13,575.60 | $24,384.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,089.48 / $19,360.31 / $30,616.00
| Facility | | $7,089.48 | $19,360.31 | $30,616.00 |