- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $10,471.29 / $10,471.29
| Facility | | $10,471.29 | $10,471.29 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $41,686.94 / $81,283.05
| Facility | | $12,022.64 | $41,686.94 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,622.78 / $41,686.94 / $43,651.58
| Facility | | $31,622.78 | $41,686.94 | $43,651.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $10,471.29 / $22,908.68
| Facility | | $10,471.29 | $10,471.29 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $15,488.17 / $22,908.68
| Facility | | $10,715.19 | $15,488.17 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $15,488.17 / $16,595.87
| Facility | | $12,022.64 | $15,488.17 | $16,595.87 |