- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,880.41 / $9,867.12 / $9,867.12
| Facility | | $8,880.41 | $9,867.12 | $9,867.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,748.10 / $6,820.34 / $11,059.00
| Facility | | $4,748.10 | $6,820.34 | $11,059.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,643.18 / $7,515.01 / $14,892.47
| Facility | | $4,643.18 | $7,515.01 | $14,892.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,156.37 / $11,139.15 / $17,073.58
| Facility | | $8,156.37 | $11,139.15 | $17,073.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,965.00 / $14,741.24 / $19,033.41
| Facility | | $6,965.00 | $14,741.24 | $19,033.41 |