- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,976.00 / $33,437.40 / $46,256.70
| Facility | | $9,976.00 | $33,437.40 | $46,256.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $10,092.62
| Facility | | $1,146.00 | $3,000.00 | $10,092.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,585.38 / $17,389.16 / $32,254.40
| Facility | | $12,585.38 | $17,389.16 | $32,254.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,585.38 / $17,956.80 / $32,254.40
| Facility | | $12,585.38 | $17,956.80 | $32,254.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $22,256.46 / $34,508.98
| Facility | | $5,419.00 | $22,256.46 | $34,508.98 |