- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,194.79 / $11,950.80 / $19,399.80
| Facility | | $8,194.79 | $11,950.80 | $19,399.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,064.95 / $15,064.95 / $22,374.08
| Facility | | $15,064.95 | $15,064.95 | $22,374.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,533.11 / $27,769.23 / $35,601.58
| Facility | | $19,533.11 | $27,769.23 | $35,601.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,622.62 / $18,604.43 / $23,531.25
| Facility | | $9,622.62 | $18,604.43 | $23,531.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,549.91 / $12,852.20 / $20,551.20
| Facility | | $8,549.91 | $12,852.20 | $20,551.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,999.02 / $17,098.45 / $25,977.52
| Facility | | $9,999.02 | $17,098.45 | $25,977.52 |