- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,538.90 / $19,999.30 / $35,218.80
| Facility | | $12,538.90 | $19,999.30 | $35,218.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,746.00 / $17,122.08 / $25,095.16
| Facility | | $6,746.00 | $17,122.08 | $25,095.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,594.26 / $15,550.52 / $26,050.76
| Facility | | $11,594.26 | $15,550.52 | $26,050.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,778.46 / $13,406.25 / $15,753.60
| Facility | | $8,778.46 | $13,406.25 | $15,753.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,409.00 / $15,106.26 / $23,485.57
| Facility | | $6,409.00 | $15,106.26 | $23,485.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,867.04 / $16,622.58 / $22,599.30
| Facility | | $11,867.04 | $16,622.58 | $22,599.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $12,526.81 / $32,632.69
| Facility | | $3,775.00 | $12,526.81 | $32,632.69 |