- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,508.50 / $19,249.00 / $27,254.50
| Facility | | $10,508.50 | $19,249.00 | $27,254.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,692.65 / $17,241.40 / $27,128.46
| Facility | | $10,692.65 | $17,241.40 | $27,128.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,925.64 / $17,315.48 / $30,806.99
| Facility | | $10,925.64 | $17,315.48 | $30,806.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,290.52 / $15,981.23 / $36,429.33
| Facility | | $6,290.52 | $15,981.23 | $36,429.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $15,459.78 / $32,373.00
| Facility | | $3,308.00 | $15,459.78 | $32,373.00 |