- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $12,035.40 / $16,144.50
| Facility | | $5,000.00 | $12,035.40 | $16,144.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,881.04 / $14,264.46 / $24,141.58
| Facility | | $11,881.04 | $14,264.46 | $24,141.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $11,406.97 / $13,563.41
| Facility | | $2,651.00 | $11,406.97 | $13,563.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,230.12 / $12,427.90 / $19,561.14
| Facility | | $10,230.12 | $12,427.90 | $19,561.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $15,354.34
| Facility | | $1,350.00 | $5,713.00 | $15,354.34 |