- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $16,982.44 / $28,840.32
| Facility | | $11,481.54 | $16,982.44 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $13,489.63 / $22,387.21
| Facility | | $10,000.00 | $13,489.63 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,589.25 / $16,595.87
| Facility | | $9,332.54 | $12,589.25 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,791.08 / $21,877.62
| Facility | | $9,332.54 | $14,791.08 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,125.38 / $19,498.45
| Facility | | $10,471.29 | $14,125.38 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $15,488.17 / $21,379.62
| Facility | | $5,370.32 | $15,488.17 | $21,379.62 |