- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,257.00 / $14,958.10 / $24,281.70
| Facility | | $10,257.00 | $14,958.10 | $24,281.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,646.77 / $27,930.82 / $35,808.74
| Facility | | $19,646.77 | $27,930.82 | $35,808.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,044.13 / $23,286.19 / $29,452.82
| Facility | | $12,044.13 | $23,286.19 | $29,452.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,701.50 / $16,086.40 / $25,722.80
| Facility | | $10,701.50 | $16,086.40 | $25,722.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,515.25 / $21,401.23 / $32,514.69
| Facility | | $12,515.25 | $21,401.23 | $32,514.69 |