- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,097.50 / $20,437.50 / $28,272.90
| Facility | | $6,097.50 | $20,437.50 | $28,272.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $37,451.83
| Facility | | $1,146.00 | $3,000.00 | $37,451.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,692.40 / $10,628.55 / $19,714.43
| Facility | | $7,692.40 | $10,628.55 | $19,714.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,692.40 / $10,628.55 / $19,714.43
| Facility | | $7,692.40 | $10,628.55 | $19,714.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,603.52 / $21,092.47
| Facility | | $5,419.00 | $13,603.52 | $21,092.47 |