- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,347.00 / $21,273.80 / $29,429.80
| Facility | | $6,347.00 | $21,273.80 | $29,429.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,018.04
| Facility | | $1,146.00 | $3,000.00 | $7,018.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,007.16 / $11,063.46 / $20,521.12
| Facility | | $8,007.16 | $11,063.46 | $20,521.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,007.16 / $11,063.46 / $20,521.12
| Facility | | $8,007.16 | $11,063.46 | $20,521.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $14,160.16 / $21,955.54
| Facility | | $5,419.00 | $14,160.16 | $21,955.54 |