- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $15,488.17 / $17,782.79
| Facility | | $12,022.64 | $15,488.17 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,378.01 / $17,378.01 / $19,498.45
| Facility | | $17,378.01 | $17,378.01 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $12,882.50 / $15,488.17
| Facility | | $10,964.78 | $12,882.50 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $17,782.79 / $22,387.21
| Facility | | $10,964.78 | $17,782.79 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $19,952.62 / $22,387.21
| Facility | | $19,952.62 | $19,952.62 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $17,378.01 / $22,908.68
| Facility | | $1,862.09 | $17,378.01 | $22,908.68 |