- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,351.36 / $9,802.40 / $13,879.20
| Facility | | $5,351.36 | $9,802.40 | $13,879.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,317.70 / $10,311.99 / $16,639.75
| Facility | | $6,317.70 | $10,311.99 | $16,639.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,563.80 / $8,817.78 / $15,688.23
| Facility | | $5,563.80 | $8,817.78 | $15,688.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,130.70 / $8,419.18 / $18,551.36
| Facility | | $4,130.70 | $8,419.18 | $18,551.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,291.00 / $16,485.71
| Facility | | $3,308.00 | $8,291.00 | $16,485.71 |