- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,461.98 / $15,482.70 / $20,768.70
| Facility | | $7,461.98 | $15,482.70 | $20,768.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,296.68 / $15,417.72 / $18,170.79
| Facility | | $8,296.68 | $15,417.72 | $18,170.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $13,541.85 / $16,101.89
| Facility | | $3,897.00 | $13,541.85 | $16,101.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,160.28 / $15,987.55 / $25,163.92
| Facility | | $13,160.28 | $15,987.55 | $25,163.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $19,752.20 / $24,945.63
| Facility | | $1,350.00 | $19,752.20 | $24,945.63 |