- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,056.10 / $15,538.60 / $31,578.60
| Facility | | $12,056.10 | $15,538.60 | $31,578.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,565.59 / $20,565.59 / $20,565.59
| Facility | | $20,565.59 | $20,565.59 | $20,565.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,196.38 / $15,288.42 / $17,478.62
| Facility | | $12,196.38 | $15,288.42 | $17,478.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,623.33 / $17,034.30 / $22,153.84
| Facility | | $9,623.33 | $17,034.30 | $22,153.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,650.43 / $23,650.43 / $23,650.43
| Facility | | $23,650.43 | $23,650.43 | $23,650.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,518.00 / $15,478.08 / $21,760.16
| Facility | | $1,518.00 | $15,478.08 | $21,760.16 |