- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,026.00 / $4,241.22 / $13,841.56
| Facility | | $1,026.00 | $4,241.22 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,665.88 / $3,864.78 / $6,782.44
| Facility | | $2,665.88 | $3,864.78 | $6,782.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $156.51 / $392.57 / $883.88
| Facility | | $156.51 | $392.57 | $883.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $419.03 / $862.94 / $1,202.61
| Facility | | $419.03 | $862.94 | $1,202.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,679.00 / $3,167.00 / $7,772.00
| Facility | | $2,679.00 | $3,167.00 | $7,772.00 |