- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,791.08 / $27,542.29
| Facility | | $9,549.93 | $14,791.08 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $11,748.98 / $17,378.01
| Facility | | $10,000.00 | $11,748.98 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,589.25 / $19,952.62
| Facility | | $8,128.31 | $12,589.25 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $11,220.18 / $21,379.62
| Facility | | $6,165.95 | $11,220.18 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,182.57 / $18,620.87
| Facility | | $6,165.95 | $13,182.57 | $18,620.87 |