- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $21,379.62 / $30,902.95
| Facility | | $14,454.40 | $21,379.62 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $17,378.01 / $28,840.32
| Facility | | $6,456.54 | $17,378.01 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $17,378.01 / $29,512.09
| Facility | | $12,882.50 | $17,378.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $19,498.45 / $28,840.32
| Facility | | $15,848.93 | $19,498.45 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $19,054.61 / $28,183.83
| Facility | | $10,000.00 | $19,054.61 | $28,183.83 |