- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,070.00 / $16,993.50 / $23,508.60
| Facility | | $5,070.00 | $16,993.50 | $23,508.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,892.27
| Facility | | $1,146.00 | $3,000.00 | $5,892.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,396.14 / $8,837.52 / $16,392.32
| Facility | | $6,396.14 | $8,837.52 | $16,392.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,396.14 / $9,126.00 / $16,392.32
| Facility | | $6,396.14 | $9,126.00 | $16,392.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,765.80 / $11,311.17 / $17,538.14
| Facility | | $4,765.80 | $11,311.17 | $17,538.14 |