- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,078.20 / $16,751.30 / $21,871.20
| Facility | | $8,078.20 | $16,751.30 | $21,871.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,099.78 / $40,963.32
| Facility | | $5,840.42 | $15,099.78 | $40,963.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,180.70 / $14,873.20 / $21,699.35
| Facility | | $10,180.70 | $14,873.20 | $21,699.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,225.51 / $22,225.51 / $22,225.51
| Facility | | $22,225.51 | $22,225.51 | $22,225.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,637.26 / $15,766.61 / $24,347.34
| Facility | | $13,637.26 | $15,766.61 | $24,347.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,099.78 / $40,963.32
| Facility | | $5,840.42 | $15,099.78 | $40,963.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,775.00 / $15,099.78 / $35,652.31
| Facility | | $3,775.00 | $15,099.78 | $35,652.31 |