- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $15,848.93 / $15,848.93
| Facility | | $15,848.93 | $15,848.93 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $23,988.33 / $31,622.78
| Facility | | $15,488.17 | $23,988.33 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $30,902.95 / $35,481.34
| Facility | | $16,218.10 | $30,902.95 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $25,703.96 / $26,915.35
| Facility | | $17,782.79 | $25,703.96 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $18,197.01 / $31,622.78
| Facility | | $17,782.79 | $18,197.01 | $31,622.78 |