- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $12,301.40 / $20,090.20
| Facility | | $6,303.00 | $12,301.40 | $20,090.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,247.27 / $22,345.57 / $29,982.94
| Facility | | $16,247.27 | $22,345.57 | $29,982.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,311.79 / $18,280.63 / $25,626.44
| Facility | | $13,311.79 | $18,280.63 | $25,626.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,589.12 / $20,302.68 / $25,595.05
| Facility | | $11,589.12 | $20,302.68 | $25,595.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,589.12 / $20,471.70 / $26,844.51
| Facility | | $11,589.12 | $20,471.70 | $26,844.51 |