- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $10,000.00 / $15,848.93
| Facility | | $1,071.52 | $10,000.00 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $27,542.29 / $32,359.37
| Facility | | $15,848.93 | $27,542.29 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $891.25 / $1,548.82
| Facility | | $616.60 | $891.25 | $1,548.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $15,135.61 / $22,387.21
| Facility | | $6,760.83 | $15,135.61 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | | $7,585.78 | $7,585.78 | $7,585.78 |