- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,183.35 / $10,748.40 / $14,033.60
| Facility | | $5,183.35 | $10,748.40 | $14,033.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $26,283.97
| Facility | | $5,840.42 | $9,750.00 | $26,283.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,073.20 / $10,042.18 / $15,173.85
| Facility | | $6,073.20 | $10,042.18 | $15,173.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,260.92 / $14,260.92 / $14,260.92
| Facility | | $14,260.92 | $14,260.92 | $14,260.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,750.29 / $10,116.59 / $15,622.39
| Facility | | $8,750.29 | $10,116.59 | $15,622.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $26,283.97
| Facility | | $5,840.42 | $9,750.00 | $26,283.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,688.71 / $20,541.16
| Facility | | $5,840.42 | $9,688.71 | $20,541.16 |