- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $11,481.54 / $31,622.78
| Facility | | $7,413.10 | $11,481.54 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $12,302.69 / $19,498.45
| Facility | | $8,511.38 | $12,302.69 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,488.17 / $20,892.96
| Facility | | $10,000.00 | $15,488.17 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,708.82 / $45,708.82 / $45,708.82
| Facility | | $45,708.82 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $15,848.93 / $24,547.09
| Facility | | $2,951.21 | $15,848.93 | $24,547.09 |