- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,150.00 / $30,668.80 / $42,426.70
| Facility | | $9,150.00 | $30,668.80 | $42,426.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $13,817.27
| Facility | | $1,146.00 | $3,000.00 | $13,817.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,543.33 / $15,949.37 / $29,583.78
| Facility | | $11,543.33 | $15,949.37 | $29,583.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,543.33 / $16,470.00 / $29,583.78
| Facility | | $11,543.33 | $16,470.00 | $29,583.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $20,413.65 / $31,651.68
| Facility | | $5,419.00 | $20,413.65 | $31,651.68 |