- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $11,481.54 / $14,791.08
| Facility | | $10,000.00 | $11,481.54 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $13,182.57 / $17,782.79
| Facility | | $5,623.41 | $13,182.57 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $12,022.64 / $20,417.38
| Facility | | $5,128.61 | $12,022.64 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151,356.12 / $151,356.12 / $151,356.12
| Facility | | $151,356.12 | $151,356.12 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $13,803.84 / $19,498.45
| Facility | | $10,715.19 | $13,803.84 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $13,182.57 / $21,379.62
| Facility | | $6,606.93 | $13,182.57 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,022.64 / $18,197.01
| Facility | | $8,128.31 | $12,022.64 | $18,197.01 |