- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,351.00 / $12,443.50 / $23,286.40
| Facility | | $6,351.00 | $12,443.50 | $23,286.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,618.00 / $1,618.00 / $2,897.50
| Facility | | $1,618.00 | $1,618.00 | $2,897.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,547.00 / $10,387.77 / $18,889.06
| Facility | | $1,547.00 | $10,387.77 | $18,889.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,072.62 / $14,322.98 / $19,848.00
| Facility | | $11,072.62 | $14,322.98 | $19,848.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,515.63 / $14,699.36 / $24,076.46
| Facility | | $7,515.63 | $14,699.36 | $24,076.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,952.00 / $14,190.70 / $20,153.90
| Facility | | $3,952.00 | $14,190.70 | $20,153.90 |