- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $19,498.45 / $30,902.95
| Facility | | $9,332.54 | $19,498.45 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $21,877.62 / $25,118.86
| Facility | | $15,848.93 | $21,877.62 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $16,982.44 / $25,703.96
| Facility | | $100.00 | $16,982.44 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $15,135.61 / $25,118.86
| Facility | | $9,772.37 | $15,135.61 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $18,197.01 / $28,183.83
| Facility | | $10,000.00 | $18,197.01 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $12,882.50 / $12,882.50
| Facility | | $12,882.50 | $12,882.50 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $14,125.38 / $27,542.29
| Facility | | $5,754.40 | $14,125.38 | $27,542.29 |