- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,548.13 / $13,586.60 / $18,225.20
| Facility | | $6,548.13 | $13,586.60 | $18,225.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,304.18 / $19,304.18 / $19,304.18
| Facility | | $19,304.18 | $19,304.18 | $19,304.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,651.00 / $11,371.76 / $13,521.55
| Facility | | $2,651.00 | $11,371.76 | $13,521.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,548.58 / $14,029.60 / $22,082.16
| Facility | | $11,548.58 | $14,029.60 | $22,082.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $5,713.00 / $17,333.20
| Facility | | $1,350.00 | $5,713.00 | $17,333.20 |