- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,358.70 / $20,000.00 / $24,577.40
| Facility | | $10,358.70 | $20,000.00 | $24,577.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,598.91 / $20,626.23 / $33,283.14
| Facility | | $12,598.91 | $20,626.23 | $33,283.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,561.98 / $21,380.01 / $29,781.58
| Facility | | $10,561.98 | $21,380.01 | $29,781.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,721.26 / $15,793.36 / $35,216.78
| Facility | | $6,721.26 | $15,793.36 | $35,216.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,081.14 / $16,238.24 / $35,216.78
| Facility | | $6,081.14 | $16,238.24 | $35,216.78 |