- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,102.66 / $12,654.70 / $16,522.50
| Facility | | $6,102.66 | $12,654.70 | $16,522.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,407.09 / $30,945.66
| Facility | | $5,840.42 | $11,407.09 | $30,945.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,150.34 / $11,823.24 / $17,865.06
| Facility | | $7,150.34 | $11,823.24 | $17,865.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,790.22 / $16,790.22 / $16,790.22
| Facility | | $16,790.22 | $16,790.22 | $16,790.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,302.24 / $11,910.85 / $18,393.15
| Facility | | $10,302.24 | $11,910.85 | $18,393.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $11,407.09 / $30,945.66
| Facility | | $5,840.42 | $11,407.09 | $30,945.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,750.00 / $24,184.31
| Facility | | $5,840.42 | $9,750.00 | $24,184.31 |