- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,724.32 / $16,642.00
| Facility | | $6,303.00 | $9,724.32 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,843.58 / $17,664.33 / $23,701.72
| Facility | | $12,843.58 | $17,664.33 | $23,701.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,523.07 / $14,450.96 / $20,257.88
| Facility | | $10,523.07 | $14,450.96 | $20,257.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,161.28 / $16,049.42 / $20,233.07
| Facility | | $9,161.28 | $16,049.42 | $20,233.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,352.14 / $14,324.83 / $20,637.68
| Facility | | $9,352.14 | $14,324.83 | $20,637.68 |