- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,747.00 / $29,318.10 / $40,558.10
| Facility | | $8,747.00 | $29,318.10 | $40,558.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,232.87
| Facility | | $1,146.00 | $3,000.00 | $7,232.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,034.92 / $15,246.90 / $28,280.80
| Facility | | $11,034.92 | $15,246.90 | $28,280.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,034.92 / $15,246.90 / $28,280.80
| Facility | | $11,034.92 | $15,246.90 | $28,280.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,514.56 / $30,257.62
| Facility | | $5,419.00 | $19,514.56 | $30,257.62 |