- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,355.00 / $24,652.40 / $34,103.69
| Facility | | $7,355.00 | $24,652.40 | $34,103.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $11,940.07
| Facility | | $1,146.00 | $3,000.00 | $11,940.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,278.82 / $12,820.50 / $23,780.19
| Facility | | $9,278.82 | $12,820.50 | $23,780.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,883.52 / $12,820.50 / $23,780.19
| Facility | | $8,883.52 | $12,820.50 | $23,780.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $16,409.00 / $25,442.42
| Facility | | $5,419.00 | $16,409.00 | $25,442.42 |