- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,449.86 / $15,682.20 / $26,036.20
| Facility | | $10,449.86 | $15,682.20 | $26,036.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,226.62 / $15,320.09 / $25,952.56
| Facility | | $10,226.62 | $15,320.09 | $25,952.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,517.60 / $16,726.91 / $24,051.28
| Facility | | $13,517.60 | $16,726.91 | $24,051.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,697.00 / $15,866.44 / $26,919.58
| Facility | | $7,697.00 | $15,866.44 | $26,919.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,697.00 / $15,531.66 / $22,533.82
| Facility | | $7,697.00 | $15,531.66 | $22,533.82 |