- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,725.25 / $9,279.78 / $15,531.10
| Facility | | $6,725.25 | $9,279.78 | $15,531.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,428.95 / $15,428.95 / $15,428.95
| Facility | | $15,428.95 | $15,428.95 | $15,428.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,423.00 / $10,752.10 / $16,256.61
| Facility | | $2,423.00 | $10,752.10 | $16,256.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,883.24 / $10,440.15 / $17,508.07
| Facility | | $6,883.24 | $10,440.15 | $17,508.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,600.00 / $8,425.78 / $18,735.68
| Facility | | $2,600.00 | $8,425.78 | $18,735.68 |