- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,915.80 / $25,993.10
| Facility | | $6,303.00 | $15,915.80 | $25,993.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,021.05 / $28,911.16 / $38,792.54
| Facility | | $21,021.05 | $28,911.16 | $38,792.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,223.07 / $23,651.85 / $33,156.01
| Facility | | $17,223.07 | $23,651.85 | $33,156.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,994.24 / $26,268.03 / $33,115.40
| Facility | | $14,994.24 | $26,268.03 | $33,115.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,994.24 / $26,486.70 / $34,731.97
| Facility | | $14,994.24 | $26,486.70 | $34,731.97 |