- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,397.50 / $18,091.30 / $25,027.10
| Facility | | $5,397.50 | $18,091.30 | $25,027.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,226.39
| Facility | | $1,146.00 | $3,000.00 | $5,226.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,809.30 / $9,408.37 / $17,451.20
| Facility | | $6,809.30 | $9,408.37 | $17,451.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,809.30 / $9,408.37 / $17,451.20
| Facility | | $6,809.30 | $9,408.37 | $17,451.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,073.64 / $13,855.38 / $18,671.03
| Facility | | $5,073.64 | $13,855.38 | $18,671.03 |