- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,597.50 / $17,597.50 / $20,856.50
| Facility | | $17,597.50 | $17,597.50 | $20,856.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,758.55 / $22,385.89 / $33,487.93
| Facility | | $13,758.55 | $22,385.89 | $33,487.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,392.56 / $17,813.84 / $30,308.18
| Facility | | $14,392.56 | $17,813.84 | $30,308.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,876.78 / $20,660.82 / $33,818.78
| Facility | | $12,876.78 | $20,660.82 | $33,818.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $202.39 / $12,773.72 / $18,250.58
| Facility | | $202.39 | $12,773.72 | $18,250.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,653.14 / $20,412.00 / $23,989.23
| Facility | | $14,653.14 | $20,412.00 | $23,989.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,224.45 / $21,772.39 / $27,445.87
| Facility | | $13,224.45 | $21,772.39 | $27,445.87 |