- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,294.00 / $29,662.40 / $48,529.60
| Facility | | $4,294.00 | $29,662.40 | $48,529.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,542.61 / $5,542.61 / $5,542.61
| Facility | | $5,542.61 | $5,542.61 | $5,542.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,426.00 / $8,740.02 / $54,660.73
| Facility | | $4,426.00 | $8,740.02 | $54,660.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,181.00 / $25,740.00 / $44,358.00
| Facility | | $3,181.00 | $25,740.00 | $44,358.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,211.00 / $9,186.00 / $48,486.39
| Facility | | $2,211.00 | $9,186.00 | $48,486.39 |