- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $13,705.50 / $22,383.50
| Facility | | $6,303.00 | $13,705.50 | $22,383.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,101.87 / $24,896.29 / $33,405.44
| Facility | | $18,101.87 | $24,896.29 | $33,405.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,831.32 / $20,367.34 / $28,551.66
| Facility | | $14,831.32 | $20,367.34 | $28,551.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,912.00 / $22,620.21 / $28,516.69
| Facility | | $12,912.00 | $22,620.21 | $28,516.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,351.82 / $21,244.28 / $29,086.97
| Facility | | $13,351.82 | $21,244.28 | $29,086.97 |