- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,782.79 / $30,199.52
| Facility | | $12,022.64 | $17,782.79 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $14,125.38 / $23,442.29
| Facility | | $10,471.29 | $14,125.38 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,589.25 / $16,218.10
| Facility | | $10,000.00 | $12,589.25 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,848.93 / $23,442.29
| Facility | | $10,000.00 | $15,848.93 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $14,791.08 / $20,417.38
| Facility | | $10,964.78 | $14,791.08 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $16,218.10 / $22,387.21
| Facility | | $5,623.41 | $16,218.10 | $22,387.21 |