- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,650.00 / $11,670.00 / $18,287.30
| Facility | | $1,650.00 | $11,670.00 | $18,287.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,041.00 / $13,301.65 / $18,386.00
| Facility | | $8,041.00 | $13,301.65 | $18,386.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,898.86 / $14,557.60 / $24,734.23
| Facility | | $9,898.86 | $14,557.60 | $24,734.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,392.00 / $14,258.00 / $18,864.00
| Facility | | $10,392.00 | $14,258.00 | $18,864.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,700.00 / $11,206.26 / $24,570.44
| Facility | | $5,700.00 | $11,206.26 | $24,570.44 |