- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $19,498.45 / $26,915.35
| Facility | | $10,471.29 | $19,498.45 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,135.61 / $24,547.09
| Facility | | $10,000.00 | $15,135.61 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $20,892.96 / $28,840.32
| Facility | | $10,232.93 | $20,892.96 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $15,135.61 / $32,359.37
| Facility | | $6,456.54 | $15,135.61 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $15,135.61 / $30,902.95
| Facility | | $5,888.44 | $15,135.61 | $30,902.95 |