- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $17,782.79 / $29,512.09
| Facility | | $8,511.38 | $17,782.79 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,218.10 / $43,651.58
| Facility | | $6,165.95 | $16,218.10 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $16,982.44 / $25,703.96
| Facility | | $10,000.00 | $16,982.44 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,218.10 / $43,651.58
| Facility | | $6,165.95 | $16,218.10 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $16,218.10 / $43,651.58
| Facility | | $6,165.95 | $16,218.10 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $13,182.57 / $38,018.94
| Facility | | $6,165.95 | $13,182.57 | $38,018.94 |