- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,122.10 / $12,122.10 / $14,367.10
| Facility | | $12,122.10 | $12,122.10 | $14,367.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,870.15 / $14,432.22 / $21,589.72
| Facility | | $8,870.15 | $14,432.22 | $21,589.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,914.41 / $12,271.18 / $20,877.99
| Facility | | $9,914.41 | $12,271.18 | $20,877.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,870.25 / $14,232.34 / $23,296.29
| Facility | | $8,870.25 | $14,232.34 | $23,296.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $130.47 / $8,235.24 / $11,887.56
| Facility | | $130.47 | $8,235.24 | $11,887.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,093.91 / $14,060.95 / $16,525.14
| Facility | | $10,093.91 | $14,060.95 | $16,525.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,109.75 / $14,998.05 / $18,906.27
| Facility | | $9,109.75 | $14,998.05 | $18,906.27 |