- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,687.50 / $19,063.30 / $26,371.80
| Facility | | $5,687.50 | $19,063.30 | $26,371.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,287.78
| Facility | | $1,146.00 | $3,000.00 | $5,287.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,175.16 / $9,913.87 / $18,388.83
| Facility | | $7,175.16 | $9,913.87 | $18,388.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,175.16 / $9,913.87 / $18,388.83
| Facility | | $7,175.16 | $9,913.87 | $18,388.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,346.25 / $12,688.81 / $19,674.20
| Facility | | $5,346.25 | $12,688.81 | $19,674.20 |