- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,297.50 / $24,459.60 / $33,837.00
| Facility | | $7,297.50 | $24,459.60 | $33,837.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,942.93
| Facility | | $1,146.00 | $3,000.00 | $7,942.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,206.28 / $12,720.27 / $23,594.28
| Facility | | $9,206.28 | $12,720.27 | $23,594.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,206.28 / $12,720.27 / $23,594.28
| Facility | | $9,206.28 | $12,720.27 | $23,594.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $16,280.72 / $25,243.51
| Facility | | $5,419.00 | $16,280.72 | $25,243.51 |