- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $18,197.01 / $33,884.42
| Facility | | $11,748.98 | $18,197.01 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $11,748.98 / $11,748.98
| Facility | | $11,748.98 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,488.17 / $24,547.09
| Facility | | $10,000.00 | $15,488.17 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $24,547.09 / $66,069.34
| Facility | | $10,471.29 | $24,547.09 | $66,069.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $17,782.79 / $26,915.35
| Facility | | $6,606.93 | $17,782.79 | $26,915.35 |