- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,743.00 / $25,952.90 / $35,902.69
| Facility | | $7,743.00 | $25,952.90 | $35,902.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.00 / $1,388.00 / $16,439.87
| Facility | | $750.00 | $1,388.00 | $16,439.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $12,003.91 / $25,034.67
| Facility | | $1,200.00 | $12,003.91 | $25,034.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $12,147.68 / $25,034.67
| Facility | | $1,200.00 | $12,147.68 | $25,034.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,400.00 / $10,561.45 / $26,784.59
| Facility | | $1,400.00 | $10,561.45 | $26,784.59 |