- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,201.80 / $21,899.60 / $29,387.50
| Facility | | $13,201.80 | $21,899.60 | $29,387.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,685.26 / $12,685.26 / $12,685.26
| Facility | | $12,685.26 | $12,685.26 | $12,685.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,343.34 / $17,771.84 / $28,435.65
| Facility | | $10,343.34 | $17,771.84 | $28,435.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,840.46 / $17,632.50 / $40,438.37
| Facility | | $10,840.46 | $17,632.50 | $40,438.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,794.14 / $17,369.18 / $25,040.50
| Facility | | $12,794.14 | $17,369.18 | $25,040.50 |