- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,593.80 / $23,988.60 / $28,965.60
| Facility | | $12,593.80 | $23,988.60 | $28,965.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,916.00 / $21,661.25 / $36,191.23
| Facility | | $6,916.00 | $21,661.25 | $36,191.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,343.20 / $20,176.70 / $24,035.62
| Facility | | $15,343.20 | $20,176.70 | $24,035.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,837.11 / $15,641.70 / $21,757.12
| Facility | | $9,837.11 | $15,641.70 | $21,757.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,416.24 / $21,102.48 / $32,105.92
| Facility | | $12,416.24 | $21,102.48 | $32,105.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,724.48 / $19,061.91 / $23,939.78
| Facility | | $13,724.48 | $19,061.91 | $23,939.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $19,751.03 / $28,451.80
| Facility | | $3,775.00 | $19,751.03 | $28,451.80 |