- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $8,511.38 / $14,125.38
| Facility | | $1,949.84 | $8,511.38 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,302.69 / $12,882.50
| Facility | | $10,000.00 | $12,302.69 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $11,220.18 / $11,220.18
| Facility | | $11,220.18 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $2,691.53 / $20,892.96
| Facility | | $1,071.52 | $2,691.53 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $6,918.31 / $11,748.98
| Facility | | $2,818.38 | $6,918.31 | $11,748.98 |