- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,518.19 / $17,435.00 / $24,686.10
| Facility | | $9,518.19 | $17,435.00 | $24,686.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,952.34 / $17,952.34 / $17,952.34
| Facility | | $17,952.34 | $17,952.34 | $17,952.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,195.98 / $17,745.70 / $28,168.41
| Facility | | $11,195.98 | $17,745.70 | $28,168.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,896.04 / $15,683.72 / $27,903.83
| Facility | | $9,896.04 | $15,683.72 | $27,903.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,297.48 / $14,797.58 / $32,996.33
| Facility | | $6,297.48 | $14,797.58 | $32,996.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $14,475.21 / $29,322.27
| Facility | | $3,308.00 | $14,475.21 | $29,322.27 |