- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,340.40 / $17,316.90 / $27,634.00
| Facility | | $12,340.40 | $17,316.90 | $27,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,932.62 / $15,328.96 / $22,360.62
| Facility | | $9,932.62 | $15,328.96 | $22,360.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,765.38 / $14,862.25 / $26,900.00
| Facility | | $10,765.38 | $14,862.25 | $26,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $114.43 / $157.62 / $251.21
| Facility | | $114.43 | $157.62 | $251.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,361.90 / $17,042.50 / $25,125.95
| Facility | | $12,361.90 | $17,042.50 | $25,125.95 |