- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,914.16 / $2,914.16 / $6,575.00
| Facility | | $2,914.16 | $2,914.16 | $6,575.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,297.59 / $17,025.45 / $28,931.30
| Facility | | $9,297.59 | $17,025.45 | $28,931.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,048.64 / $10,001.00 / $24,058.77
| Facility | | $7,048.64 | $10,001.00 | $24,058.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,407.86 / $9,143.32 / $18,943.91
| Facility | | $6,407.86 | $9,143.32 | $18,943.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,005.23 / $4,990.88 / $8,742.50
| Facility | | $3,005.23 | $4,990.88 | $8,742.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |