- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,644.49 / $19,999.20 / $26,111.80
| Facility | | $9,644.49 | $19,999.20 | $26,111.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,027.48 / $48,905.74
| Facility | | $5,840.42 | $18,027.48 | $48,905.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,300.21 / $18,685.15 / $28,233.49
| Facility | | $11,300.21 | $18,685.15 | $28,233.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,534.84 / $26,534.84 / $26,534.84
| Facility | | $26,534.84 | $26,534.84 | $26,534.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,281.40 / $18,823.61 / $29,068.07
| Facility | | $16,281.40 | $18,823.61 | $29,068.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $18,027.48 / $48,905.74
| Facility | | $5,840.42 | $18,027.48 | $48,905.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,203.28 / $38,220.26
| Facility | | $5,840.42 | $14,203.28 | $38,220.26 |