- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,848.93 / $42,657.95
| Facility | | $10,000.00 | $15,848.93 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $23,988.33 / $38,018.94
| Facility | | $16,595.87 | $23,988.33 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $21,379.62 / $28,183.83
| Facility | | $13,489.63 | $21,379.62 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,659.50 / $61,659.50 / $61,659.50
| Facility | | $61,659.50 | $61,659.50 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $21,379.62 / $32,359.37
| Facility | | $3,801.89 | $21,379.62 | $32,359.37 |