- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,581.30 / $21,954.90 / $29,450.60
| Facility | | $10,581.30 | $21,954.90 | $29,450.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,027.33 / $18,027.33 / $25,063.60
| Facility | | $18,027.33 | $18,027.33 | $25,063.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,897.00 / $18,590.04 / $22,104.42
| Facility | | $3,897.00 | $18,590.04 | $22,104.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,661.65 / $22,670.80 / $35,683.15
| Facility | | $18,661.65 | $22,670.80 | $35,683.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,350.00 / $28,009.18 / $35,373.61
| Facility | | $1,350.00 | $28,009.18 | $35,373.61 |