- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $15,488.17 / $23,442.29
| Facility | | $11,220.18 | $15,488.17 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $13,803.84 / $19,952.62
| Facility | | $8,709.64 | $13,803.84 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $13,489.63 / $23,988.33
| Facility | | $9,549.93 | $13,489.63 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102.33 / $151.36 / $223.87
| Facility | | $102.33 | $151.36 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,135.61 / $21,877.62
| Facility | | $10,000.00 | $15,135.61 | $21,877.62 |