- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,349.98 / $19,400.00 / $26,023.50
| Facility | | $9,349.98 | $19,400.00 | $26,023.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,975.56 / $42,975.56 / $42,975.56
| Facility | | $42,975.56 | $42,975.56 | $42,975.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $21,182.62 / $25,187.12
| Facility | | $3,897.00 | $21,182.62 | $25,187.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,490.03 / $20,032.65 / $31,530.78
| Facility | | $16,490.03 | $20,032.65 | $31,530.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $24,749.81 / $31,257.26
| Facility | | $1,350.00 | $24,749.81 | $31,257.26 |