- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,663.10 / $16,774.00 / $29,348.20
| Facility | | $12,663.10 | $16,774.00 | $29,348.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,697.90 / $14,697.90 / $14,697.90
| Facility | | $14,697.90 | $14,697.90 | $14,697.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,939.30 / $14,692.82 / $29,927.47
| Facility | | $5,939.30 | $14,692.82 | $29,927.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,618.17 / $17,036.59 / $26,202.83
| Facility | | $11,618.17 | $17,036.59 | $26,202.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,496.00 / $17,286.45 / $26,402.92
| Facility | | $3,496.00 | $17,286.45 | $26,402.92 |