- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $19,649.00 / $32,710.20
| Facility | | $3,821.00 | $19,649.00 | $32,710.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,385.70 / $28,514.47 / $47,838.90
| Facility | | $10,385.70 | $28,514.47 | $47,838.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,945.58 / $25,123.51 / $44,813.25
| Facility | | $17,945.58 | $25,123.51 | $44,813.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,446.19 / $27,909.55 / $40,750.21
| Facility | | $21,446.19 | $27,909.55 | $40,750.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,742.74 / $26,856.91 / $40,750.21
| Facility | | $17,742.74 | $26,856.91 | $40,750.21 |