- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,729.83 / $2,596.35 / $8,229.00
| Facility | | $1,729.83 | $2,596.35 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,720.89 / $10,099.00 / $25,551.65
| Facility | | $7,720.89 | $10,099.00 | $25,551.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,407.52 / $3,304.45 / $3,811.91
| Facility | | $2,407.52 | $3,304.45 | $3,811.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,917.75 / $2,917.75 / $2,917.75
| Facility | | $2,917.75 | $2,917.75 | $2,917.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.00 / $2,513.00 / $27,879.00
| Facility | | $405.00 | $2,513.00 | $27,879.00 |