- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,088.50 / $17,055.59 / $23,594.40
| Facility | | $5,088.50 | $17,055.59 | $23,594.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $4,694.89
| Facility | | $1,146.00 | $3,000.00 | $4,694.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,419.48 / $8,869.76 / $16,452.14
| Facility | | $6,419.48 | $8,869.76 | $16,452.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,922.96 / $8,869.76 / $16,452.14
| Facility | | $5,922.96 | $8,869.76 | $16,452.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,783.18 / $11,352.44 / $17,602.14
| Facility | | $4,783.18 | $11,352.44 | $17,602.14 |