- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,740.00 / $28,457.00 / $28,457.00
| Facility | | $3,740.00 | $28,457.00 | $28,457.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,209.00 / $32,617.32 / $40,770.06
| Facility | | $23,209.00 | $32,617.32 | $40,770.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,637.70 / $36,477.15 / $73,218.00
| Facility | | $14,637.70 | $36,477.15 | $73,218.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,701.56 / $26,909.84 / $28,255.00
| Facility | | $17,701.56 | $26,909.84 | $28,255.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,525.00 / $35,708.00 / $61,467.88
| Facility | | $35,525.00 | $35,708.00 | $61,467.88 |