- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,785.50 / $16,040.00 / $22,189.40
| Facility | | $4,785.50 | $16,040.00 | $22,189.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,146.00 / $2,268.35 / $3,588.66
| Facility | | $1,146.00 | $2,268.35 | $3,588.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,037.22 / $8,341.61 / $15,472.48
| Facility | | $6,037.22 | $8,341.61 | $15,472.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,037.22 / $8,613.90 / $15,472.48
| Facility | | $6,037.22 | $8,613.90 | $15,472.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.00 / $7,050.00 / $16,554.00
| Facility | | $3,800.00 | $7,050.00 | $16,554.00 |