- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,867.46 / $10,747.80 / $15,217.70
| Facility | | $5,867.46 | $10,747.80 | $15,217.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,426.52 / $10,519.50 / $16,981.97
| Facility | | $6,426.52 | $10,519.50 | $16,981.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,100.38 / $9,668.18 / $17,201.22
| Facility | | $6,100.38 | $9,668.18 | $17,201.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,529.07 / $8,923.19 / $20,340.48
| Facility | | $4,529.07 | $8,923.19 | $20,340.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $8,923.19 / $18,075.61
| Facility | | $3,308.00 | $8,923.19 | $18,075.61 |