- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,052.00 / $4,241.22 / $13,841.56
| Facility | | $2,052.00 | $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
- $155.37 / $279.67 / $618.73
| Facility | | $155.37 | $279.67 | $618.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $311.88 / $443.38 / $1,139.33
| Facility | | $311.88 | $443.38 | $1,139.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,467.76 / $2,003.56 / $7,772.00
| Facility | | $1,467.76 | $2,003.56 | $7,772.00 |