- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,963.40 / $13,071.60 / $21,219.40
| Facility | | $8,963.40 | $13,071.60 | $21,219.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,260.80 / $16,260.80 / $16,260.80
| Facility | | $16,260.80 | $16,260.80 | $16,260.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,160.06 / $30,082.18 / $38,566.90
| Facility | | $21,160.06 | $30,082.18 | $38,566.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,525.14 / $20,349.37 / $25,738.27
| Facility | | $10,525.14 | $20,349.37 | $25,738.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,351.81 / $14,057.60 / $22,478.70
| Facility | | $9,351.81 | $14,057.60 | $22,478.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,936.84 / $18,702.13 / $28,413.98
| Facility | | $10,936.84 | $18,702.13 | $28,413.98 |