- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,020.00 / $20,177.70 / $27,913.50
| Facility | | $6,020.00 | $20,177.70 | $27,913.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,922.47
| Facility | | $1,146.00 | $3,000.00 | $7,922.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,594.63 / $10,493.46 / $19,463.86
| Facility | | $7,594.63 | $10,493.46 | $19,463.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,594.63 / $10,836.00 / $19,463.86
| Facility | | $7,594.63 | $10,836.00 | $19,463.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,430.62 / $20,824.38
| Facility | | $5,419.00 | $13,430.62 | $20,824.38 |