- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,379.20 / $12,584.00 / $14,508.60
| Facility | | $10,379.20 | $12,584.00 | $14,508.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,347.96 / $13,347.96 / $16,423.70
| Facility | | $13,347.96 | $13,347.96 | $16,423.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,067.00 / $4,334.00
| Facility | | $1,252.00 | $3,067.00 | $4,334.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,233.02 / $14,696.42 / $25,223.66
| Facility | | $9,233.02 | $14,696.42 | $25,223.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $21,845.64
| Facility | | $2,332.00 | $5,310.00 | $21,845.64 |