- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $17,378.01 / $26,302.68
| Facility | | $13,489.63 | $17,378.01 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $13,489.63 / $21,877.62
| Facility | | $8,128.31 | $13,489.63 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $16,595.87 / $25,118.86
| Facility | | $6,918.31 | $16,595.87 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $13,803.84 / $25,703.96
| Facility | | $10,000.00 | $13,803.84 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $11,481.54 / $20,892.96
| Facility | | $3,311.31 | $11,481.54 | $20,892.96 |