- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,488.17 / $42,657.95
| Facility | | $10,000.00 | $15,488.17 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $16,982.44 / $26,302.68
| Facility | | $11,748.98 | $16,982.44 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $20,892.96 / $28,183.83
| Facility | | $13,182.57 | $20,892.96 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,659.50 / $61,659.50 / $61,659.50
| Facility | | $61,659.50 | $61,659.50 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $21,379.62 / $33,113.11
| Facility | | $2,951.21 | $21,379.62 | $33,113.11 |