- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,882.50 / $28,183.83
| Facility | | $10,000.00 | $12,882.50 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $8,128.31 / $10,964.78
| Facility | | $8,128.31 | $8,128.31 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,897.79 / $11,481.54 / $19,952.62
| Facility | | $4,897.79 | $11,481.54 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $13,182.57 / $19,498.45
| Facility | | $10,232.93 | $13,182.57 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $12,882.50 / $22,908.68
| Facility | | $8,511.38 | $12,882.50 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $11,481.54 / $17,378.01
| Facility | | $7,943.28 | $11,481.54 | $17,378.01 |