- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $16,595.87 / $31,622.78
| Facility | | $9,332.54 | $16,595.87 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $18,197.01 / $30,199.52
| Facility | | $10,232.93 | $18,197.01 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $12,302.69 / $26,302.68
| Facility | | $100.00 | $12,302.69 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,791.08 / $25,703.96
| Facility | | $10,471.29 | $14,791.08 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $25,703.96 / $25,703.96
| Facility | | $25,703.96 | $25,703.96 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $16,595.87 / $30,199.52
| Facility | | $10,232.93 | $16,595.87 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $14,125.38 / $28,840.32
| Facility | | $5,754.40 | $14,125.38 | $28,840.32 |