- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,794.00 / $16,068.50 / $22,228.80
| Facility | | $4,794.00 | $16,068.50 | $22,228.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,434.71
| Facility | | $1,146.00 | $3,000.00 | $5,434.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,047.95 / $8,356.42 / $15,499.96
| Facility | | $6,047.95 | $8,356.42 | $15,499.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,047.95 / $8,629.20 / $15,499.96
| Facility | | $6,047.95 | $8,629.20 | $15,499.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $10,907.00 / $16,583.40
| Facility | | $5,419.00 | $10,907.00 | $16,583.40 |