- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,306.19 / $10,000.00 / $18,733.70
| Facility | | $6,306.19 | $10,000.00 | $18,733.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.92 / $11,312.98 / $18,714.78
| Facility | | $7,943.92 | $11,312.98 | $18,714.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,736.47 / $9,812.92 / $14,126.11
| Facility | | $5,736.47 | $9,812.92 | $14,126.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,026.05 / $20,026.05 / $23,502.27
| Facility | | $20,026.05 | $20,026.05 | $23,502.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $9,277.81 / $13,252.29
| Facility | | $1,787.00 | $9,277.81 | $13,252.29 |