- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,641.50 / $22,260.90 / $30,795.30
| Facility | | $6,641.50 | $22,260.90 | $30,795.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,881.58
| Facility | | $1,146.00 | $3,000.00 | $5,881.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,378.69 / $11,576.80 / $21,473.30
| Facility | | $8,378.69 | $11,576.80 | $21,473.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,559.64 / $11,576.80 / $21,473.30
| Facility | | $7,559.64 | $11,576.80 | $21,473.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $14,817.19 / $22,974.28
| Facility | | $5,419.00 | $14,817.19 | $22,974.28 |