- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,507.20 / $15,567.20 / $20,325.20
| Facility | | $7,507.20 | $15,567.20 | $20,325.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,032.47 / $38,067.89
| Facility | | $5,840.42 | $14,032.47 | $38,067.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,796.01 / $14,544.39 / $21,976.75
| Facility | | $8,796.01 | $14,544.39 | $21,976.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,654.53 / $20,654.53 / $20,654.53
| Facility | | $20,654.53 | $20,654.53 | $20,654.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,673.33 / $14,652.17 / $22,626.38
| Facility | | $12,673.33 | $14,652.17 | $22,626.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $14,032.47 / $38,067.89
| Facility | | $5,840.42 | $14,032.47 | $38,067.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $14,032.47 / $33,132.28
| Facility | | $3,775.00 | $14,032.47 | $33,132.28 |