- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,079.20 / $17,865.80 / $17,865.80
| Facility | | $16,079.20 | $17,865.80 | $17,865.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,131.72 / $19,700.78 / $20,837.40
| Facility | | $11,131.72 | $19,700.78 | $20,837.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,532.04 / $12,204.48 / $22,287.36
| Facility | | $7,532.04 | $12,204.48 | $22,287.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,364.00 / $20,158.00 / $30,914.00
| Facility | | $14,364.00 | $20,158.00 | $30,914.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $26,691.00 / $34,462.55
| Facility | | $6,965.00 | $26,691.00 | $34,462.55 |