- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,233.00 / $17,539.90 / $24,264.40
| Facility | | $5,233.00 | $17,539.90 | $24,264.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,504.93
| Facility | | $1,146.00 | $3,000.00 | $5,504.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,601.77 / $9,121.64 / $16,919.34
| Facility | | $6,601.77 | $9,121.64 | $16,919.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,601.77 / $9,121.64 / $16,919.34
| Facility | | $6,601.77 | $9,121.64 | $16,919.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,919.02 / $11,810.60 / $18,629.48
| Facility | | $4,919.02 | $11,810.60 | $18,629.48 |