- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $10,506.90 / $17,159.59
| Facility | | $6,303.00 | $10,506.90 | $17,159.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,877.20 / $19,085.91 / $25,609.18
| Facility | | $13,877.20 | $19,085.91 | $25,609.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,369.94 / $15,613.95 / $21,888.19
| Facility | | $11,369.94 | $15,613.95 | $21,888.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,898.56 / $17,341.04 / $21,861.38
| Facility | | $9,898.56 | $17,341.04 | $21,861.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,898.56 / $17,485.39 / $22,928.57
| Facility | | $9,898.56 | $17,485.39 | $22,928.57 |