- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,022.64 / $14,454.40
| Facility | | $10,000.00 | $12,022.64 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $10,964.78 / $17,378.01
| Facility | | $10,715.19 | $10,964.78 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $12,302.69 / $19,498.45
| Facility | | $9,549.93 | $12,302.69 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $16,218.10 / $16,218.10
| Facility | | $7,079.46 | $16,218.10 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $13,803.84 / $20,417.38
| Facility | | $10,000.00 | $13,803.84 | $20,417.38 |