- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $23,304.80 / $30,427.80
| Facility | | $3,822.00 | $23,304.80 | $30,427.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,282.10 / $62,503.28
| Facility | | $5,840.42 | $21,282.10 | $62,503.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,168.01 / $21,773.59 / $32,900.16
| Facility | | $13,168.01 | $21,773.59 | $32,900.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,920.74 / $30,920.74 / $30,920.74
| Facility | | $30,920.74 | $30,920.74 | $30,920.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,972.53 / $21,934.93 / $33,872.69
| Facility | | $18,972.53 | $21,934.93 | $33,872.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,282.10 / $62,503.28
| Facility | | $5,840.42 | $21,282.10 | $62,503.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $21,282.10 / $44,537.64
| Facility | | $5,840.42 | $21,282.10 | $44,537.64 |