- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,002.00 / $16,765.59 / $23,193.30
| Facility | | $5,002.00 | $16,765.59 | $23,193.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,500.05 / $3,896.50
| Facility | | $1,146.00 | $2,500.05 | $3,896.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,310.35 / $8,718.99 / $16,172.47
| Facility | | $6,310.35 | $8,718.99 | $16,172.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,310.35 / $9,003.60 / $16,172.47
| Facility | | $6,310.35 | $9,003.60 | $16,172.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.00 / $7,050.00 / $17,302.91
| Facility | | $3,800.00 | $7,050.00 | $17,302.91 |