- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $16,173.00 / $25,905.00
| Facility | | $4,804.00 | $16,173.00 | $25,905.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $687.00 / $2,767.00 / $16,782.50
| Facility | | $687.00 | $2,767.00 | $16,782.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,811.21 / $15,918.95 / $27,628.20
| Facility | | $9,811.21 | $15,918.95 | $27,628.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,335.10 / $34,922.19 / $34,922.19
| Facility | | $21,335.10 | $34,922.19 | $34,922.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,090.04 / $14,283.75 / $27,628.20
| Facility | | $10,090.04 | $14,283.75 | $27,628.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,456.53 / $12,798.24 / $29,259.98
| Facility | | $4,456.53 | $12,798.24 | $29,259.98 |