- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,032.21 / $12,975.80 / $17,955.20
| Facility | | $8,032.21 | $12,975.80 | $17,955.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,010.16 / $20,010.16 / $20,010.16
| Facility | | $20,010.16 | $20,010.16 | $20,010.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,602.30 / $12,181.61 / $18,455.40
| Facility | | $7,602.30 | $12,181.61 | $18,455.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $10,855.94 / $18,097.21
| Facility | | $6,564.00 | $10,855.94 | $18,097.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,564.00 / $10,721.22 / $16,497.91
| Facility | | $6,564.00 | $10,721.22 | $16,497.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,264.00 / $13,970.21 / $19,957.70
| Facility | | $7,264.00 | $13,970.21 | $19,957.70 |