- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,410.70 / $12,678.60 / $12,678.60
| Facility | | $11,410.70 | $12,678.60 | $12,678.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,244.82 / $10,244.82 / $10,244.82
| Facility | | $10,244.82 | $10,244.82 | $10,244.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,650.83 / $9,048.86 / $21,236.82
| Facility | | $5,650.83 | $9,048.86 | $21,236.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,480.37 / $14,522.51 / $21,938.38
| Facility | | $10,480.37 | $14,522.51 | $21,938.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,196.15 / $18,519.59 / $29,749.21
| Facility | | $7,196.15 | $18,519.59 | $29,749.21 |