- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,570.00 / $28,724.80 / $39,737.40
| Facility | | $8,570.00 | $28,724.80 | $39,737.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $3,000.00 / $7,336.10
| Facility | | $1,146.00 | $3,000.00 | $7,336.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,811.62 / $14,938.37 / $27,708.52
| Facility | | $10,811.62 | $14,938.37 | $27,708.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,811.62 / $15,426.00 / $27,708.52
| Facility | | $10,811.62 | $15,426.00 | $27,708.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,419.00 / $19,119.66 / $29,645.34
| Facility | | $5,419.00 | $19,119.66 | $29,645.34 |