- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,120.00 / $6,906.00 / $16,682.30
| Facility | | $2,120.00 | $6,906.00 | $16,682.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,117.00 / $13,891.97 / $25,142.54
| Facility | | $8,117.00 | $13,891.97 | $25,142.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,835.13 / $11,407.56 / $17,339.84
| Facility | | $5,835.13 | $11,407.56 | $17,339.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,411.33 / $18,832.86 / $28,866.14
| Facility | | $10,411.33 | $18,832.86 | $28,866.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,785.00 / $12,234.00 / $26,770.09
| Facility | | $4,785.00 | $12,234.00 | $26,770.09 |