- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $10,295.00 / $16,813.40
| Facility | | $6,303.00 | $10,295.00 | $16,813.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,597.26 / $18,700.91 / $25,092.58
| Facility | | $13,597.26 | $18,700.91 | $25,092.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,140.58 / $15,298.97 / $21,446.65
| Facility | | $11,140.58 | $15,298.97 | $21,446.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,698.87 / $16,991.23 / $21,420.38
| Facility | | $9,698.87 | $16,991.23 | $21,420.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,698.87 / $17,132.66 / $22,466.04
| Facility | | $9,698.87 | $17,132.66 | $22,466.04 |