- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,692.50 / $18,547.30 / $18,547.30
| Facility | | $16,692.50 | $18,547.30 | $18,547.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,765.63 / $12,765.63 / $12,765.63
| Facility | | $12,765.63 | $12,765.63 | $12,765.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,351.18 / $17,296.75 / $30,014.67
| Facility | | $9,351.18 | $17,296.75 | $30,014.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,666.49 / $20,421.14 / $32,093.26
| Facility | | $14,666.49 | $20,421.14 | $32,093.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $27,709.16 / $35,777.17
| Facility | | $6,965.00 | $27,709.16 | $35,777.17 |