- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,948.50 / $19,938.09 / $27,582.00
| Facility | | $5,948.50 | $19,938.09 | $27,582.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $4,737.22
| Facility | | $1,146.00 | $3,000.00 | $4,737.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,504.43 / $10,368.83 / $19,232.68
| Facility | | $7,504.43 | $10,368.83 | $19,232.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,504.43 / $10,368.83 / $19,232.68
| Facility | | $7,504.43 | $10,368.83 | $19,232.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $13,271.10 / $20,577.05
| Facility | | $5,419.00 | $13,271.10 | $20,577.05 |