- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,747.00 / $22,614.50 / $31,284.50
| Facility | | $6,747.00 | $22,614.50 | $31,284.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $8,448.37
| Facility | | $1,146.00 | $3,000.00 | $8,448.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.79 / $11,760.70 / $21,814.40
| Facility | | $8,511.79 | $11,760.70 | $21,814.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.79 / $11,760.70 / $21,814.40
| Facility | | $8,511.79 | $11,760.70 | $21,814.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $15,052.56 / $23,339.22
| Facility | | $5,419.00 | $15,052.56 | $23,339.22 |