- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $17,148.80 / $28,006.80
| Facility | | $6,303.00 | $17,148.80 | $28,006.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,649.55 / $31,150.90 / $41,797.78
| Facility | | $22,649.55 | $31,150.90 | $41,797.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,557.34 / $25,484.15 / $35,724.60
| Facility | | $18,557.34 | $25,484.15 | $35,724.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,155.84 / $28,303.01 / $35,680.85
| Facility | | $16,155.84 | $28,303.01 | $35,680.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,155.84 / $28,538.62 / $37,422.65
| Facility | | $16,155.84 | $28,538.62 | $37,422.65 |