- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $7,943.28 / $24,547.09
| Facility | | $2,187.76 | $7,943.28 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,344.23 / $2,818.38
| Professional | | $1,737.80 | $2,344.23 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,862.09 / $3,019.95
| Facility | | $1,174.90 | $1,862.09 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $2,290.87 / $2,398.83
| Facility | | $1,737.80 | $2,290.87 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,819.70 / $2,570.40
| Facility | | $1,174.90 | $1,819.70 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $10,000.00 / $26,302.68
| Facility | | $6,918.31 | $10,000.00 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $17,782.79 / $31,622.78
| Facility | | $2,884.03 | $17,782.79 | $31,622.78 |