- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,804.00 / $17,569.40 / $26,528.40
| Facility | | $4,804.00 | $17,569.40 | $26,528.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.00 / $3,027.00 / $18,432.16
| Facility | | $688.00 | $3,027.00 | $18,432.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,047.34 / $16,302.06 / $28,293.10
| Facility | | $10,047.34 | $16,302.06 | $28,293.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,989.40 / $39,266.86 / $39,266.86
| Facility | | $23,989.40 | $39,266.86 | $39,266.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,332.87 / $14,627.50 / $28,293.10
| Facility | | $10,332.87 | $14,627.50 | $28,293.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,563.78 / $13,106.24 / $29,964.14
| Facility | | $4,563.78 | $13,106.24 | $29,964.14 |