- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $14,125.38 / $16,595.87
| Facility | | $9,120.11 | $14,125.38 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $15,135.61 / $20,417.38
| Facility | | $10,232.93 | $15,135.61 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $18,197.01
| Facility | | $8,912.51 | $13,803.84 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $14,454.40 / $19,952.62
| Facility | | $10,000.00 | $14,454.40 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $14,454.40 / $21,877.62
| Facility | | $4,073.80 | $14,454.40 | $21,877.62 |