- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,001.50 / $33,522.90 / $46,375.00
| Facility | | $10,001.50 | $33,522.90 | $46,375.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $13,099.31
| Facility | | $1,146.00 | $3,000.00 | $13,099.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,617.55 / $17,433.61 / $32,336.85
| Facility | | $12,617.55 | $17,433.61 | $32,336.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,617.55 / $17,433.61 / $32,336.85
| Facility | | $12,617.55 | $17,433.61 | $32,336.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $22,313.35 / $34,597.19
| Facility | | $5,419.00 | $22,313.35 | $34,597.19 |