- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,134.00 / $13,813.80 / $18,035.90
| Facility | | $1,134.00 | $13,813.80 | $18,035.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,451.90 / $33,780.05
| Facility | | $5,840.42 | $12,451.90 | $33,780.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,805.26 / $12,906.16 / $19,501.37
| Facility | | $7,805.26 | $12,906.16 | $19,501.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,328.08 / $18,328.08 / $18,328.08
| Facility | | $18,328.08 | $18,328.08 | $18,328.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,245.85 / $13,001.80 / $20,077.83
| Facility | | $11,245.85 | $13,001.80 | $20,077.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $12,451.90 / $33,780.05
| Facility | | $5,840.42 | $12,451.90 | $33,780.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $9,810.45 / $26,399.41
| Facility | | $5,840.42 | $9,810.45 | $26,399.41 |