- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $15,135.61 / $40,738.03
| Facility | | $9,772.37 | $15,135.61 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $14,454.40 / $22,387.21
| Facility | | $10,000.00 | $14,454.40 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $20,417.38 / $27,542.29
| Facility | | $12,882.50 | $20,417.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58,884.37 / $58,884.37 / $58,884.37
| Facility | | $58,884.37 | $58,884.37 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $21,877.62 / $31,622.78
| Facility | | $3,801.89 | $21,877.62 | $31,622.78 |