- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $9,772.37 / $19,498.45
| Facility | | $3,235.94 | $9,772.37 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,135.61 / $18,620.87
| Facility | | $10,000.00 | $15,135.61 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $13,489.63 / $18,620.87
| Facility | | $8,511.38 | $13,489.63 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $11,220.18 / $28,183.83
| Facility | | $6,309.57 | $11,220.18 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $10,000.00 / $16,595.87
| Facility | | $4,073.80 | $10,000.00 | $16,595.87 |