- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,002.00 / $23,335.68 / $40,158.00
| Facility | | $4,002.00 | $23,335.68 | $40,158.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,812.00 / $5,812.00 / $6,916.00
| Facility | | $5,812.00 | $5,812.00 | $6,916.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,035.00 / $27,973.02 / $33,443.54
| Facility | | $19,035.00 | $27,973.02 | $33,443.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,400.00 / $21,069.80 / $31,116.92
| Facility | | $2,400.00 | $21,069.80 | $31,116.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,034.00 / $25,406.14 / $37,906.33
| Facility | | $3,034.00 | $25,406.14 | $37,906.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $2,388.00 / $21,082.19
| Facility | | $1,500.00 | $2,388.00 | $21,082.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $27,382.87 / $39,445.62
| Facility | | $3,775.00 | $27,382.87 | $39,445.62 |