- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,843.82 / $12,914.60 / $16,974.20
| Facility | | $8,843.82 | $12,914.60 | $16,974.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,761.80 / $12,968.16 / $21,933.90
| Facility | | $4,761.80 | $12,968.16 | $21,933.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,984.11 / $12,972.01 / $23,245.03
| Facility | | $8,984.11 | $12,972.01 | $23,245.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,124.33 / $14,476.93 / $21,137.50
| Facility | | $11,124.33 | $14,476.93 | $21,137.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,124.33 / $13,458.24 / $21,137.50
| Facility | | $11,124.33 | $13,458.24 | $21,137.50 |