- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $10,982.80 / $17,936.70
| Facility | | $6,303.00 | $10,982.80 | $17,936.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,505.72 / $19,950.34 / $26,769.06
| Facility | | $14,505.72 | $19,950.34 | $26,769.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,884.90 / $16,321.13 / $22,879.54
| Facility | | $11,884.90 | $16,321.13 | $22,879.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,346.87 / $18,126.43 / $22,851.52
| Facility | | $10,346.87 | $18,126.43 | $22,851.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,346.87 / $18,277.33 / $23,967.04
| Facility | | $10,346.87 | $18,277.33 | $23,967.04 |