- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $10,000.00 / $30,199.52
| Facility | | $4,570.88 | $10,000.00 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $18,620.87 / $38,018.94
| Facility | | $6,606.93 | $18,620.87 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $28,183.83
| Facility | | $851.14 | $851.14 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $23,988.33 / $25,703.96
| Facility | | $22,908.68 | $23,988.33 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $15,135.61 / $23,442.29
| Facility | | $9,332.54 | $15,135.61 | $23,442.29 |