- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $12,899.50 / $21,067.10
| Facility | | $6,303.00 | $12,899.50 | $21,067.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,037.29 / $23,432.13 / $31,440.85
| Facility | | $17,037.29 | $23,432.13 | $31,440.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,959.08 / $19,169.52 / $26,872.53
| Facility | | $13,959.08 | $19,169.52 | $26,872.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,152.64 / $21,289.91 / $26,839.61
| Facility | | $12,152.64 | $21,289.91 | $26,839.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,152.64 / $21,467.13 / $28,149.82
| Facility | | $12,152.64 | $21,467.13 | $28,149.82 |