- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,429.20 / $16,848.00 / $23,313.30
| Facility | | $10,429.20 | $16,848.00 | $23,313.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,376.91 / $13,376.91 / $13,376.91
| Facility | | $13,376.91 | $13,376.91 | $13,376.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,566.39 / $15,328.79 / $23,223.44
| Facility | | $9,566.39 | $15,328.79 | $23,223.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,322.07 / $14,095.55 / $24,130.82
| Facility | | $7,322.07 | $14,095.55 | $24,130.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,322.07 / $14,095.55 / $23,497.74
| Facility | | $7,322.07 | $14,095.55 | $23,497.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,538.19 / $17,374.00 / $26,213.32
| Facility | | $8,538.19 | $17,374.00 | $26,213.32 |