- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,173.00 / $27,394.10 / $37,896.60
| Facility | | $8,173.00 | $27,394.10 | $37,896.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $5,702.09
| Facility | | $1,146.00 | $3,000.00 | $5,702.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,310.78 / $14,246.36 / $26,424.94
| Facility | | $10,310.78 | $14,246.36 | $26,424.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,310.78 / $14,246.36 / $26,424.94
| Facility | | $10,310.78 | $14,246.36 | $26,424.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $18,233.96 / $28,272.04
| Facility | | $5,419.00 | $18,233.96 | $28,272.04 |