- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $5,495.41 / $10,000.00
| Facility | | $1,023.29 | $5,495.41 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $8,709.64 / $12,022.64
| Facility | | $6,918.31 | $8,709.64 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $812.83 / $1,023.29
| Professional | | $676.08 | $812.83 | $1,023.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $851.14 / $1,047.13 / $1,819.70
| Professional | | $851.14 | $1,047.13 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $1,023.29 / $1,778.28
| Facility | | $776.25 | $1,023.29 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,071.52 / $11,481.54
| Facility | | $588.84 | $1,071.52 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $12,882.50 / $29,512.09
| Facility | | $8,317.64 | $12,882.50 | $29,512.09 |