- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,508.10 / $21,790.10 / $28,450.00
| Facility | | $10,508.10 | $21,790.10 | $28,450.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,641.80 / $53,285.13
| Facility | | $5,840.42 | $19,641.80 | $53,285.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,243.06 / $19,347.08 / $28,226.53
| Facility | | $13,243.06 | $19,347.08 | $28,226.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,910.97 / $28,910.97 / $28,910.97
| Facility | | $28,910.97 | $28,910.97 | $28,910.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,739.36 / $20,509.21 / $31,671.04
| Facility | | $17,739.36 | $20,509.21 | $31,671.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $19,641.80 / $53,285.13
| Facility | | $5,840.42 | $19,641.80 | $53,285.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $15,475.15 / $41,642.80
| Facility | | $5,840.42 | $15,475.15 | $41,642.80 |