- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $9,549.93 / $13,489.63
| Facility | | $3,981.07 | $9,549.93 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $10,232.93 / $17,782.79
| Facility | | $5,754.40 | $10,232.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,302.69 / $19,952.62
| Facility | | $8,128.31 | $12,302.69 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $9,549.93 / $19,952.62
| Facility | | $6,760.83 | $9,549.93 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,120.11 / $16,982.44
| Facility | | $5,888.44 | $9,120.11 | $16,982.44 |