- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,884.50 / $11,884.50 / $14,085.50
| Facility | | $11,884.50 | $11,884.50 | $14,085.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,891.60 / $12,840.06 / $19,207.95
| Facility | | $7,891.60 | $12,840.06 | $19,207.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,720.08 / $12,030.66 / $20,468.77
| Facility | | $9,720.08 | $12,030.66 | $20,468.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,696.39 / $13,953.38 / $22,839.67
| Facility | | $8,696.39 | $13,953.38 | $22,839.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.09 / $7,326.73 / $11,608.93
| Facility | | $116.09 | $7,326.73 | $11,608.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,896.07 / $13,785.35 / $16,201.24
| Facility | | $9,896.07 | $13,785.35 | $16,201.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,931.20 / $14,704.08 / $18,535.70
| Facility | | $8,931.20 | $14,704.08 | $18,535.70 |