- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,056.50 / $14,685.50 / $19,301.80
| Facility | | $10,056.50 | $14,685.50 | $19,301.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,323.69 / $9,051.66 / $15,309.66
| Facility | | $3,323.69 | $9,051.66 | $15,309.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,216.03 / $14,750.75 / $24,689.43
| Facility | | $10,216.03 | $14,750.75 | $24,689.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,649.72 / $16,462.04 / $24,035.92
| Facility | | $12,649.72 | $16,462.04 | $24,035.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,649.72 / $15,303.66 / $24,035.92
| Facility | | $12,649.72 | $15,303.66 | $24,035.92 |