- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,559.00 / $13,954.50 / $13,954.50
| Facility | | $12,559.00 | $13,954.50 | $13,954.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,253.96 / $10,253.96 / $10,253.96
| Facility | | $10,253.96 | $10,253.96 | $10,253.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,352.26 / $10,841.14 / $21,351.82
| Facility | | $7,352.26 | $10,841.14 | $21,351.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,535.04 / $15,745.00 / $24,146.10
| Facility | | $11,535.04 | $15,745.00 | $24,146.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $20,847.62 / $26,917.77
| Facility | | $6,965.00 | $20,847.62 | $26,917.77 |