- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,408.00 / $28,181.80 / $38,986.19
| Facility | | $8,408.00 | $28,181.80 | $38,986.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $4,829.75
| Facility | | $1,146.00 | $3,000.00 | $4,829.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,607.25 / $14,655.98 / $27,184.75
| Facility | | $10,607.25 | $14,655.98 | $27,184.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,607.25 / $14,655.98 / $27,184.75
| Facility | | $10,607.25 | $14,655.98 | $27,184.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $18,758.25 / $29,084.95
| Facility | | $5,419.00 | $18,758.25 | $29,084.95 |