- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $21,877.62 / $45,708.82
| Facility | | $10,000.00 | $21,877.62 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $38,904.51 / $47,863.01
| Facility | | $25,703.96 | $38,904.51 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $28,183.83 / $38,904.51
| Facility | | $15,488.17 | $28,183.83 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $28,840.32 / $72,443.60
| Facility | | $16,218.10 | $28,840.32 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $19,498.45 / $38,904.51
| Facility | | $6,606.93 | $19,498.45 | $38,904.51 |