- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $28,840.32 / $37,153.52
| Facility | | $19,498.45 | $28,840.32 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $12,302.69 / $26,302.68
| Facility | | $6,606.93 | $12,302.69 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $14,125.38 / $25,703.96
| Facility | | $10,000.00 | $14,125.38 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $14,125.38 / $25,703.96
| Facility | | $10,000.00 | $14,125.38 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $17,782.79 / $28,840.32
| Facility | | $5,370.32 | $17,782.79 | $28,840.32 |