- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,175.00 / $44,259.50 / $61,230.00
| Facility | | $5,175.00 | $44,259.50 | $61,230.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,246.58 / $23,706.00 / $36,635.08
| Facility | | $5,246.58 | $23,706.00 | $36,635.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,609.59 / $38,134.47 / $59,184.75
| Facility | | $17,609.59 | $38,134.47 | $59,184.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,586.52 / $36,738.00 / $84,254.93
| Facility | | $22,586.52 | $36,738.00 | $84,254.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,583.00 / $35,660.35 / $52,172.86
| Facility | | $11,583.00 | $35,660.35 | $52,172.86 |