- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $9,963.00 / $15,619.60
| Facility | | $4,804.00 | $9,963.00 | $15,619.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $2,697.25 / $10,087.20
| Facility | | $688.00 | $2,697.25 | $10,087.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,915.75 / $9,331.12 / $16,658.64
| Facility | | $5,915.75 | $9,331.12 | $16,658.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,144.20 / $21,514.98 / $21,514.98
| Facility | | $13,144.20 | $21,514.98 | $21,514.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,781.00 / $11,781.00 / $64,480.86
| Facility | | $11,781.00 | $11,781.00 | $64,480.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,083.87 / $8,612.50 / $16,658.64
| Facility | | $6,083.87 | $8,612.50 | $16,658.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,307.20 / $7,716.80 / $17,642.53
| Facility | | $3,307.20 | $7,716.80 | $17,642.53 |