- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,700.40 / $18,546.40 / $24,376.40
| Facility | | $12,700.40 | $18,546.40 | $24,376.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,915.00 / $18,915.00 / $18,915.00
| Facility | | $18,915.00 | $18,915.00 | $18,915.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,514.17 / $17,740.53 / $30,005.72
| Facility | | $6,514.17 | $17,740.53 | $30,005.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,367.81 / $18,714.70 / $33,381.74
| Facility | | $13,367.81 | $18,714.70 | $33,381.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,975.43 / $20,790.04 / $30,355.15
| Facility | | $15,975.43 | $20,790.04 | $30,355.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,975.43 / $19,327.11 / $30,355.15
| Facility | | $15,975.43 | $19,327.11 | $30,355.15 |