- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,486.00 / $25,091.50 / $34,711.10
| Facility | | $7,486.00 | $25,091.50 | $34,711.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $13,113.73
| Facility | | $1,146.00 | $3,000.00 | $13,113.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,444.08 / $13,048.85 / $24,203.74
| Facility | | $9,444.08 | $13,048.85 | $24,203.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,444.08 / $13,474.80 / $24,203.74
| Facility | | $9,444.08 | $13,474.80 | $24,203.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $16,701.27 / $25,895.57
| Facility | | $5,419.00 | $16,701.27 | $25,895.57 |