- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,758.00 / $10,218.60 / $16,812.00
| Facility | | $3,758.00 | $10,218.60 | $16,812.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,646.94 / $10,646.94 / $10,646.94
| Facility | | $10,646.94 | $10,646.94 | $10,646.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,494.00 / $11,222.65 / $17,386.00
| Facility | | $3,494.00 | $11,222.65 | $17,386.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,579.62 / $11,496.39 / $19,279.38
| Facility | | $7,579.62 | $11,496.39 | $19,279.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,062.00 / $11,723.26 / $20,698.20
| Facility | | $4,062.00 | $11,723.26 | $20,698.20 |