- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,534.70 / $25,370.70
| Facility | | $6,303.00 | $15,534.70 | $25,370.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,517.70 / $28,218.88 / $37,863.64
| Facility | | $20,517.70 | $28,218.88 | $37,863.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,810.66 / $23,085.50 / $32,362.09
| Facility | | $16,810.66 | $23,085.50 | $32,362.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,635.20 / $25,639.04 / $32,322.45
| Facility | | $14,635.20 | $25,639.04 | $32,322.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,635.20 / $25,852.47 / $33,900.31
| Facility | | $14,635.20 | $25,852.47 | $33,900.31 |