- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,720.34 / $8,766.66 / $14,554.70
| Facility | | $5,720.34 | $8,766.66 | $14,554.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,485.62 / $9,504.00 / $13,544.98
| Facility | | $8,485.62 | $9,504.00 | $13,544.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,198.85 / $7,788.20 / $13,193.37
| Facility | | $5,198.85 | $7,788.20 | $13,193.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,556.59 / $9,350.66 / $13,445.10
| Facility | | $7,556.59 | $9,350.66 | $13,445.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,697.50 / $9,387.48 / $23,247.25
| Facility | | $4,697.50 | $9,387.48 | $23,247.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,697.50 / $9,187.56 / $12,596.82
| Facility | | $4,697.50 | $9,187.56 | $12,596.82 |