- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,595.87 / $30,902.95
| Facility | | $9,332.54 | $16,595.87 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $17,782.79 / $30,199.52
| Facility | | $10,232.93 | $17,782.79 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $17,782.79 / $34,673.69
| Facility | | $100.00 | $17,782.79 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $14,791.08 / $25,703.96
| Facility | | $10,000.00 | $14,791.08 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $25,703.96
| Facility | | $25,703.96 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $16,218.10 / $29,512.09
| Facility | | $10,000.00 | $16,218.10 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $14,125.38 / $28,183.83
| Facility | | $5,754.40 | $14,125.38 | $28,183.83 |