- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $17,782.79 / $23,988.33
| Facility | | $11,220.18 | $17,782.79 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $31,622.78 / $38,904.51
| Facility | | $21,379.62 | $31,622.78 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $15,848.93 / $22,387.21
| Facility | | $11,481.54 | $15,848.93 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,379.62 / $21,379.62 / $21,379.62
| Facility | | $21,379.62 | $21,379.62 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,488.17 / $24,547.09
| Facility | | $10,000.00 | $15,488.17 | $24,547.09 |