- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,974.10 / $10,943.10 / $15,494.30
| Facility | | $5,974.10 | $10,943.10 | $15,494.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,075.34 / $9,801.36 / $15,446.54
| Facility | | $6,075.34 | $9,801.36 | $15,446.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,211.26 / $9,843.91 / $17,513.87
| Facility | | $6,211.26 | $9,843.91 | $17,513.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,611.39 / $9,085.37 / $20,710.18
| Facility | | $4,611.39 | $9,085.37 | $20,710.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $9,085.37 / $18,404.15
| Facility | | $3,308.00 | $9,085.37 | $18,404.15 |