- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $12,087.40 / $19,740.70
| Facility | | $6,303.00 | $12,087.40 | $19,740.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,964.64 / $21,956.86 / $29,461.36
| Facility | | $15,964.64 | $21,956.86 | $29,461.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,080.23 / $17,962.63 / $25,180.65
| Facility | | $13,080.23 | $17,962.63 | $25,180.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,387.52 / $19,949.50 / $25,149.81
| Facility | | $11,387.52 | $19,949.50 | $25,149.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,387.52 / $20,115.58 / $26,377.53
| Facility | | $11,387.52 | $20,115.58 | $26,377.53 |