- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,862.00 / $6,653.00 / $9,637.10
| Facility | | $2,862.00 | $6,653.00 | $9,637.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,873.00 / $9,678.00 / $12,904.00
| Facility | | $8,873.00 | $9,678.00 | $12,904.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,212.00 / $4,326.79 / $4,326.79
| Facility | | $2,212.00 | $4,326.79 | $4,326.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,469.34 / $5,378.00 / $5,486.00
| Facility | | $4,469.34 | $5,378.00 | $5,486.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,325.00 / $7,843.00 / $11,371.00
| Facility | | $5,325.00 | $7,843.00 | $11,371.00 |