- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,203.50 / $20,792.80 / $28,764.40
| Facility | | $6,203.50 | $20,792.80 | $28,764.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,323.33
| Facility | | $1,146.00 | $3,000.00 | $6,323.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,826.12 / $10,813.32 / $20,057.16
| Facility | | $7,826.12 | $10,813.32 | $20,057.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,826.12 / $10,813.32 / $20,057.16
| Facility | | $7,826.12 | $10,813.32 | $20,057.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,840.01 / $21,459.15
| Facility | | $5,419.00 | $13,840.01 | $21,459.15 |