- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $16,057.40 / $26,224.50
| Facility | | $6,303.00 | $16,057.40 | $26,224.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,208.12 / $29,168.45 / $39,137.76
| Facility | | $21,208.12 | $29,168.45 | $39,137.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,376.34 / $23,862.34 / $33,451.08
| Facility | | $17,376.34 | $23,862.34 | $33,451.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,127.68 / $26,501.80 / $33,410.11
| Facility | | $15,127.68 | $26,501.80 | $33,410.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,127.68 / $26,722.42 / $35,041.06
| Facility | | $15,127.68 | $26,722.42 | $35,041.06 |