- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,251.79 / $13,579.90 / $23,759.70
| Facility | | $10,251.79 | $13,579.90 | $23,759.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,000.00 / $11,302.87 / $18,464.41
| Facility | | $6,000.00 | $11,302.87 | $18,464.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,786.47 / $11,762.95 / $24,047.45
| Facility | | $5,786.47 | $11,762.95 | $24,047.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,728.09 / $13,792.45 / $21,213.23
| Facility | | $9,728.09 | $13,792.45 | $21,213.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $13,994.73 / $21,375.22
| Facility | | $3,496.00 | $13,994.73 | $21,375.22 |