- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,158.94 / $13,773.60 / $24,237.60
| Facility | | $8,158.94 | $13,773.60 | $24,237.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,658.21 / $9,658.21 / $13,853.10
| Facility | | $9,658.21 | $9,658.21 | $13,853.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,453.94 / $9,526.65 / $15,751.79
| Facility | | $6,453.94 | $9,526.65 | $15,751.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,421.83 / $12,695.93 / $17,666.15
| Facility | | $7,421.83 | $12,695.93 | $17,666.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,301.25 / $26,301.25 / $30,866.75
| Facility | | $26,301.25 | $26,301.25 | $30,866.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $12,003.61 / $17,145.78
| Facility | | $1,787.00 | $12,003.61 | $17,145.78 |