- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $23,442.29 / $30,199.52
| Facility | | $15,848.93 | $23,442.29 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $10,000.00 / $21,379.62
| Facility | | $5,128.61 | $10,000.00 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,481.54 / $21,379.62
| Facility | | $8,317.64 | $11,481.54 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $11,481.54 / $21,379.62
| Facility | | $8,317.64 | $11,481.54 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $14,791.08 / $23,442.29
| Facility | | $5,370.32 | $14,791.08 | $23,442.29 |