- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,488.17 / $42,657.95
| Facility | | $10,000.00 | $15,488.17 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $15,135.61 / $23,442.29
| Facility | | $10,471.29 | $15,135.61 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $20,892.96 / $28,183.83
| Facility | | $13,489.63 | $20,892.96 | $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
- $2,951.21 / $21,877.62 / $33,113.11
| Facility | | $2,951.21 | $21,877.62 | $33,113.11 |