- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,308.43 / $14,071.60 / $18,873.40
| Facility | | $8,308.43 | $14,071.60 | $18,873.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,552.45 / $27,552.45 / $27,552.45
| Facility | | $27,552.45 | $27,552.45 | $27,552.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,361.79 / $15,172.71 / $17,871.48
| Facility | | $8,361.79 | $15,172.71 | $17,871.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,084.59 / $15,387.52 / $21,556.80
| Facility | | $8,084.59 | $15,387.52 | $21,556.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,622.12 / $16,785.65 / $21,556.80
| Facility | | $14,622.12 | $16,785.65 | $21,556.80 |