- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,848.00 / $19,601.20 / $27,116.00
| Facility | | $5,848.00 | $19,601.20 | $27,116.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $6,084.78
| Facility | | $1,146.00 | $3,000.00 | $6,084.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,377.64 / $10,193.65 / $18,907.75
| Facility | | $7,377.64 | $10,193.65 | $18,907.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,377.64 / $10,193.65 / $18,907.75
| Facility | | $7,377.64 | $10,193.65 | $18,907.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,046.89 / $20,229.40
| Facility | | $5,419.00 | $13,046.89 | $20,229.40 |