- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,317.20 / $7,754.25 / $12,587.60
| Facility | | $5,317.20 | $7,754.25 | $12,587.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,348.80 / $15,348.80 / $15,348.80
| Facility | | $15,348.80 | $15,348.80 | $15,348.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,371.76 / $13,365.54 / $17,161.25
| Facility | | $9,371.76 | $13,365.54 | $17,161.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,243.64 / $12,071.50 / $15,268.26
| Facility | | $6,243.64 | $12,071.50 | $15,268.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,547.61 / $8,339.14 / $13,334.70
| Facility | | $5,547.61 | $8,339.14 | $13,334.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,487.87 / $11,094.34 / $16,855.52
| Facility | | $6,487.87 | $11,094.34 | $16,855.52 |