- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,300.50 / $17,766.09 / $24,577.40
| Facility | | $5,300.50 | $17,766.09 | $24,577.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,754.17
| Facility | | $1,146.00 | $3,000.00 | $5,754.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,686.93 / $9,239.29 / $17,137.58
| Facility | | $6,686.93 | $9,239.29 | $17,137.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,686.93 / $9,540.90 / $17,137.58
| Facility | | $6,686.93 | $9,540.90 | $17,137.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,982.47 / $10,371.00 / $18,335.49
| Facility | | $4,982.47 | $10,371.00 | $18,335.49 |