- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $16,595.87 / $25,703.96
| Facility | | $12,882.50 | $16,595.87 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $11,481.54 / $19,498.45
| Facility | | $10,000.00 | $11,481.54 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $17,378.01 / $24,547.09
| Facility | | $6,918.31 | $17,378.01 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,182.57 / $24,547.09
| Facility | | $9,549.93 | $13,182.57 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,311.31 / $11,481.54 / $19,952.62
| Facility | | $3,311.31 | $11,481.54 | $19,952.62 |