- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $11,748.98 / $31,622.78
| Facility | | $7,585.78 | $11,748.98 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $14,454.40 / $14,454.40
| Facility | | $14,454.40 | $14,454.40 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $28,183.83 / $43,651.58
| Facility | | $19,498.45 | $28,183.83 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,848.93 / $20,892.96
| Facility | | $10,000.00 | $15,848.93 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,708.82 / $45,708.82 / $45,708.82
| Facility | | $45,708.82 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $16,218.10 / $25,118.86
| Facility | | $2,951.21 | $16,218.10 | $25,118.86 |