- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,963.73 / $12,374.00 / $16,598.59
| Facility | | $5,963.73 | $12,374.00 | $16,598.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,544.22 / $17,544.22 / $17,544.22
| Facility | | $17,544.22 | $17,544.22 | $17,544.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $13,266.56 / $15,774.56
| Facility | | $3,897.00 | $13,266.56 | $15,774.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,517.90 / $12,777.50 / $20,111.39
| Facility | | $10,517.90 | $12,777.50 | $20,111.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.00 / $14,599.98 / $19,936.93
| Facility | | $1,500.00 | $14,599.98 | $19,936.93 |