- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,006.00 / $23,482.60 / $32,485.40
| Facility | | $7,006.00 | $23,482.60 | $32,485.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,179.65
| Facility | | $1,146.00 | $3,000.00 | $6,179.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,838.53 / $12,212.16 / $22,651.80
| Facility | | $8,838.53 | $12,212.16 | $22,651.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,838.53 / $12,212.16 / $22,651.80
| Facility | | $8,838.53 | $12,212.16 | $22,651.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $16,503.45 / $24,235.16
| Facility | | $5,419.00 | $16,503.45 | $24,235.16 |