- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $7,943.28 / $15,135.61
| Facility | | $4,570.88 | $7,943.28 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $9,772.37 / $19,054.61
| Facility | | $7,413.10 | $9,772.37 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,174.90 / $10,471.29
| Facility | | $660.69 | $1,174.90 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,380.38 / $1,621.81 / $2,238.72
| Professional | | $1,380.38 | $1,621.81 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $7,585.78 / $7,585.78
| Facility | | $7,585.78 | $7,585.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,413.10 / $9,549.93
| Facility | | $6,309.57 | $7,413.10 | $9,549.93 |