- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,416.56 / $11,232.00 / $14,665.00
| Facility | | $5,416.56 | $11,232.00 | $14,665.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,124.64 / $27,466.56
| Facility | | $5,840.42 | $10,124.64 | $27,466.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,346.45 / $10,494.00 / $15,856.56
| Facility | | $6,346.45 | $10,494.00 | $15,856.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,902.56 / $14,902.56 / $14,902.56
| Facility | | $14,902.56 | $14,902.56 | $14,902.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,144.00 / $10,571.76 / $16,325.28
| Facility | | $9,144.00 | $10,571.76 | $16,325.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $10,124.64 / $27,466.56
| Facility | | $5,840.42 | $10,124.64 | $27,466.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $21,465.36
| Facility | | $5,840.42 | $9,750.00 | $21,465.36 |