- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,956.28 / $9,288.09 / $11,835.10
| Facility | | $5,956.28 | $9,288.09 | $11,835.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,267.78 / $17,267.78 / $17,267.78
| Facility | | $17,267.78 | $17,267.78 | $17,267.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,325.49 / $9,514.45 / $11,206.80
| Facility | | $5,325.49 | $9,514.45 | $11,206.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,069.66 / $9,649.17 / $13,517.78
| Facility | | $5,069.66 | $9,649.17 | $13,517.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,169.20 / $10,525.90 / $13,517.78
| Facility | | $9,169.20 | $10,525.90 | $13,517.78 |