- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $11,748.98 / $15,135.61
| Facility | | $10,000.00 | $11,748.98 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $11,220.18 / $11,220.18
| Facility | | $11,220.18 | $11,220.18 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $12,302.69 / $20,417.38
| Facility | | $5,128.61 | $12,302.69 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $14,125.38 / $21,379.62
| Facility | | $10,715.19 | $14,125.38 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $13,489.63 / $21,379.62
| Facility | | $6,760.83 | $13,489.63 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,302.69 / $18,197.01
| Facility | | $8,317.64 | $12,302.69 | $18,197.01 |