- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,022.64 / $26,915.35
| Facility | | $8,317.64 | $12,022.64 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $14,125.38
| Facility | | $10,000.00 | $10,000.00 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $12,302.69 / $20,892.96
| Facility | | $8,511.38 | $12,302.69 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,125.38 / $26,915.35
| Facility | | $9,772.37 | $14,125.38 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $18,620.87 / $28,183.83
| Facility | | $6,918.31 | $18,620.87 | $28,183.83 |