- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,606.80 / $6,718.25 / $10,905.80
| Facility | | $4,606.80 | $6,718.25 | $10,905.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,757.98 / $9,757.98 / $9,757.98
| Facility | | $9,757.98 | $9,757.98 | $9,757.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,756.61 / $12,448.83 / $15,960.04
| Facility | | $8,756.61 | $12,448.83 | $15,960.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,409.47 / $10,458.70 / $13,228.36
| Facility | | $5,409.47 | $10,458.70 | $13,228.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,806.43 / $7,225.00 / $11,553.10
| Facility | | $4,806.43 | $7,225.00 | $11,553.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,621.06 / $9,612.09 / $14,603.56
| Facility | | $5,621.06 | $9,612.09 | $14,603.56 |