- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $11,812.20 / $19,291.40
| Facility | | $6,303.00 | $11,812.20 | $19,291.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,601.26 / $21,457.08 / $28,790.77
| Facility | | $15,601.26 | $21,457.08 | $28,790.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,782.50 / $17,553.77 / $24,607.50
| Facility | | $12,782.50 | $17,553.77 | $24,607.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,128.32 / $19,495.43 / $24,577.36
| Facility | | $11,128.32 | $19,495.43 | $24,577.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,128.32 / $19,657.71 / $25,777.13
| Facility | | $11,128.32 | $19,657.71 | $25,777.13 |