- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,193.00 / $37,516.50 / $51,899.70
| Facility | | $11,193.00 | $37,516.50 | $51,899.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $14,420.38
| Facility | | $1,146.00 | $3,000.00 | $14,420.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,120.71 / $19,510.52 / $36,189.21
| Facility | | $14,120.71 | $19,510.52 | $36,189.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,120.71 / $20,147.40 / $36,189.21
| Facility | | $14,120.71 | $20,147.40 | $36,189.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $24,971.58 / $38,718.83
| Facility | | $5,419.00 | $24,971.58 | $38,718.83 |