- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $6,440.08 / $13,475.90
| Facility | | $6,303.00 | $6,440.08 | $13,475.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,505.86 / $11,698.48 / $15,696.83
| Facility | | $8,505.86 | $11,698.48 | $15,696.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,969.06 / $9,570.37 / $13,416.10
| Facility | | $6,969.06 | $9,570.37 | $13,416.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,067.20 / $10,628.98 / $13,399.66
| Facility | | $6,067.20 | $10,628.98 | $13,399.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,067.20 / $10,717.46 / $14,053.78
| Facility | | $6,067.20 | $10,717.46 | $14,053.78 |