- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,116.50 / $17,149.40 / $23,724.20
| Facility | | $5,116.50 | $17,149.40 | $23,724.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,481.18
| Facility | | $1,146.00 | $3,000.00 | $7,481.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,454.80 / $8,918.57 / $16,542.66
| Facility | | $6,454.80 | $8,918.57 | $16,542.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,454.80 / $9,209.70 / $16,542.66
| Facility | | $6,454.80 | $9,209.70 | $16,542.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,809.51 / $12,794.71 / $17,699.00
| Facility | | $4,809.51 | $12,794.71 | $17,699.00 |