- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,848.93 / $25,703.96
| Facility | | $11,220.18 | $15,848.93 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $11,481.54 / $19,054.61
| Facility | | $7,943.28 | $11,481.54 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $11,220.18 / $18,620.87
| Facility | | $5,495.41 | $11,220.18 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $16,218.10 / $30,199.52
| Facility | | $10,000.00 | $16,218.10 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,810.72 / $39,810.72 / $39,810.72
| Facility | | $39,810.72 | $39,810.72 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $15,488.17 / $25,703.96
| Facility | | $6,025.60 | $15,488.17 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $14,454.40 / $33,113.11
| Facility | | $9,772.37 | $14,454.40 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $13,489.63 / $30,199.52
| Facility | | $5,248.07 | $13,489.63 | $30,199.52 |