- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,135.61 / $20,417.38
| Facility | | $10,000.00 | $15,135.61 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $13,803.84 / $13,803.84
| Facility | | $13,803.84 | $13,803.84 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $15,135.61 / $19,952.62
| Facility | | $7,244.36 | $15,135.61 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,882.50 / $19,054.61
| Facility | | $8,317.64 | $12,882.50 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $14,454.40 / $21,379.62
| Facility | | $6,165.95 | $14,454.40 | $21,379.62 |