- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $19,498.45 / $25,118.86
| Facility | | $14,125.38 | $19,498.45 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $17,378.01 / $23,988.33
| Facility | | $10,000.00 | $17,378.01 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $20,417.38 / $28,840.32
| Facility | | $10,715.19 | $20,417.38 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $16,982.44 / $22,908.68
| Facility | | $10,000.00 | $16,982.44 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,232.93 / $20,417.38 / $28,840.32
| Facility | | $10,232.93 | $20,417.38 | $28,840.32 |