- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $16,637.20 / $27,171.40
| Facility | | $6,303.00 | $16,637.20 | $27,171.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,973.92 / $30,221.69 / $40,550.98
| Facility | | $21,973.92 | $30,221.69 | $40,550.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,003.78 / $24,723.98 / $34,658.96
| Facility | | $18,003.78 | $24,723.98 | $34,658.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,673.92 / $27,458.75 / $34,616.51
| Facility | | $15,673.92 | $27,458.75 | $34,616.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,673.92 / $27,687.33 / $36,306.35
| Facility | | $15,673.92 | $27,687.33 | $36,306.35 |