- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $18,620.87 / $18,620.87
| Facility | | $18,620.87 | $18,620.87 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $25,118.86 / $44,668.36
| Facility | | $15,488.17 | $25,118.86 | $44,668.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,234.13 / $74,131.02 / $77,624.71
| Facility | | $56,234.13 | $74,131.02 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $18,620.87 / $45,708.82
| Facility | | $18,620.87 | $18,620.87 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $30,199.52 / $45,708.82
| Facility | | $19,952.62 | $30,199.52 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $30,199.52 / $57,543.99
| Facility | | $21,877.62 | $30,199.52 | $57,543.99 |