- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $21,379.62 / $30,199.52
| Facility | | $12,022.64 | $21,379.62 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $25,703.96 / $34,673.69
| Facility | | $15,848.93 | $25,703.96 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $19,952.62 / $29,512.09
| Facility | | $11,748.98 | $19,952.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,908.68 / $22,908.68 / $27,542.29
| Facility | | $22,908.68 | $22,908.68 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $21,379.62 / $26,915.35
| Facility | | $9,549.93 | $21,379.62 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $33,884.42 / $40,738.03
| Facility | | $10,000.00 | $33,884.42 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $21,379.62 / $29,512.09
| Facility | | $11,748.98 | $21,379.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $12,022.64 / $19,952.62
| Facility | | $10,000.00 | $12,022.64 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $15,488.17 / $27,542.29
| Facility | | $5,370.32 | $15,488.17 | $27,542.29 |