- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $17,782.79 / $33,884.42
| Facility | | $11,481.54 | $17,782.79 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $14,125.38 / $20,892.96
| Facility | | $10,715.19 | $14,125.38 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,135.61 / $24,547.09
| Facility | | $10,000.00 | $15,135.61 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $11,481.54 / $24,547.09
| Facility | | $3,388.44 | $11,481.54 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $15,848.93 / $22,387.21
| Facility | | $6,309.57 | $15,848.93 | $22,387.21 |