- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,549.93 / $15,488.17
| Facility | | $5,888.44 | $9,549.93 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $25,118.86 / $26,302.68
| Facility | | $19,054.61 | $25,118.86 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $13,803.84 / $15,488.17
| Facility | | $6,309.57 | $13,803.84 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $10,471.29 / $15,488.17
| Facility | | $7,413.10 | $10,471.29 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $9,332.54 / $10,232.93
| Facility | | $7,413.10 | $9,332.54 | $10,232.93 |