- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,488.17 / $29,512.09
| Facility | | $10,000.00 | $15,488.17 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $17,378.01 / $17,378.01
| Facility | | $17,378.01 | $17,378.01 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $13,182.57 / $21,379.62
| Facility | | $8,709.64 | $13,182.57 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $14,791.08 / $28,840.32
| Facility | | $7,413.10 | $14,791.08 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $14,125.38 / $19,952.62
| Facility | | $6,309.57 | $14,125.38 | $19,952.62 |