- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $20,892.96 / $26,915.35
| Facility | | $14,125.38 | $20,892.96 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $8,912.51 / $19,054.61
| Facility | | $4,786.30 | $8,912.51 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,000.00 / $18,620.87
| Facility | | $7,244.36 | $10,000.00 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,000.00 / $18,620.87
| Facility | | $7,244.36 | $10,000.00 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $12,882.50 / $20,417.38
| Facility | | $5,370.32 | $12,882.50 | $20,417.38 |