- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,012.50 / $20,152.59 / $27,878.80
| Facility | | $6,012.50 | $20,152.59 | $27,878.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,957.50 / $4,504.25
| Facility | | $1,146.00 | $2,957.50 | $4,504.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.17 / $10,480.39 / $19,439.62
| Facility | | $7,585.17 | $10,480.39 | $19,439.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.17 / $10,480.39 / $19,439.62
| Facility | | $7,585.17 | $10,480.39 | $19,439.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,413.89 / $20,798.43
| Facility | | $5,419.00 | $13,413.89 | $20,798.43 |