- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,538.40 / $17,791.20 / $23,069.60
| Facility | | $11,538.40 | $17,791.20 | $23,069.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,194.87 / $17,658.00 / $23,969.80
| Facility | | $10,194.87 | $17,658.00 | $23,969.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,926.00 / $12,918.00 / $20,022.00
| Facility | | $7,926.00 | $12,918.00 | $20,022.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $21,860.49
| Facility | | $6,098.00 | $18,065.00 | $21,860.49 |