- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,762.82 / $1,941.06 / $4,846.00
| Facility | | $1,762.82 | $1,941.06 | $4,846.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,600.00 / $8,980.45 / $14,278.45
| Facility | | $4,600.00 | $8,980.45 | $14,278.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,617.55 / $2,102.82 / $2,426.33
| Facility | | $1,617.55 | $2,102.82 | $2,426.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.00 / $761.00 / $2,053.92
| Facility | | $761.00 | $761.00 | $2,053.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $612.00 / $5,076.00 / $10,396.00
| Facility | | $612.00 | $5,076.00 | $10,396.00 |