- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,005.00 / $10,563.53 / $20,928.72
| Facility | | $5,005.00 | $10,563.53 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,211.62 / $5,707.82 / $10,715.04
| Facility | | $4,211.62 | $5,707.82 | $10,715.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,054.08 / $1,882.88 / $8,757.16
| Facility | | $1,054.08 | $1,882.88 | $8,757.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,850.00 / $2,466.64 / $3,316.21
| Facility | | $1,850.00 | $2,466.64 | $3,316.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |