- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $5,128.61 / $16,218.10
| Facility | | $1,202.26 | $5,128.61 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $18,620.87 / $31,622.78
| Facility | | $15,488.17 | $18,620.87 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $15,848.93 / $15,848.93
| Facility | | $15,848.93 | $15,848.93 | $15,848.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,398.83 / $8,709.64
| Professional | | $1,513.56 | $2,398.83 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $9,772.37 / $25,703.96
| Facility | | $2,570.40 | $9,772.37 | $25,703.96 |