- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $19,054.61 / $26,302.68
| Facility | | $10,232.93 | $19,054.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $16,982.44 / $27,542.29
| Facility | | $10,964.78 | $16,982.44 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $20,417.38 / $28,183.83
| Facility | | $10,000.00 | $20,417.38 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $14,791.08 / $30,199.52
| Facility | | $6,309.57 | $14,791.08 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $14,791.08 / $29,512.09
| Facility | | $5,754.40 | $14,791.08 | $29,512.09 |