- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $6,760.83 / $9,772.37
| Facility | | $2,398.83 | $6,760.83 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $21,877.62 / $34,673.69
| Facility | | $10,000.00 | $21,877.62 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $12,589.25 / $12,589.25
| Facility | | $12,589.25 | $12,589.25 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,479.11 / $2,344.23
| Facility | | $1,479.11 | $1,479.11 | $2,344.23 |