- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,245.00 / $5,764.64 / $10,768.00
| Facility | | $1,245.00 | $5,764.64 | $10,768.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,010.49 / $1,420.44 / $2,033.00
| Facility | | $1,010.49 | $1,420.44 | $2,033.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,801.10 / $19,913.50 / $26,542.00
| Facility | | $5,801.10 | $19,913.50 | $26,542.00 |