- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,746.50 / $29,316.40 / $40,555.80
| Facility | | $8,746.50 | $29,316.40 | $40,555.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,618.35
| Facility | | $1,146.00 | $3,000.00 | $7,618.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,034.29 / $15,246.02 / $28,279.18
| Facility | | $11,034.29 | $15,246.02 | $28,279.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,034.29 / $15,273.84 / $28,279.18
| Facility | | $11,034.29 | $15,273.84 | $28,279.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,513.43 / $30,255.89
| Facility | | $5,419.00 | $19,513.43 | $30,255.89 |