- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,626.50 / $25,562.40 / $35,362.60
| Facility | | $7,626.50 | $25,562.40 | $35,362.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,132.93
| Facility | | $1,146.00 | $3,000.00 | $5,132.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,621.33 / $13,293.75 / $24,658.00
| Facility | | $9,621.33 | $13,293.75 | $24,658.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,621.33 / $13,727.70 / $24,658.00
| Facility | | $9,621.33 | $13,727.70 | $24,658.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $17,014.72 / $26,381.59
| Facility | | $5,419.00 | $17,014.72 | $26,381.59 |