- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $5,623.41 / $22,908.68
| Facility | | $1,659.59 | $5,623.41 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $15,488.17 / $27,542.29
| Facility | | $7,244.36 | $15,488.17 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $14,791.08 / $20,892.96
| Facility | | $398.11 | $14,791.08 | $20,892.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,698.24 / $4,466.84 / $8,912.51
| Professional | | $1,698.24 | $4,466.84 | $8,912.51 |
- 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
- $1,584.89 / $7,762.47 / $16,982.44
| Facility | | $1,584.89 | $7,762.47 | $16,982.44 |