- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,488.17 / $28,840.32
| Facility | | $10,000.00 | $15,488.17 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $14,791.08 / $16,982.44
| Facility | | $14,791.08 | $14,791.08 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $12,882.50 / $20,892.96
| Facility | | $8,511.38 | $12,882.50 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $11,220.18 / $21,877.62
| Facility | | $5,888.44 | $11,220.18 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $13,803.84 / $19,498.45
| Facility | | $6,309.57 | $13,803.84 | $19,498.45 |